to heavy coinsurance and deductibles with high out-of-pocket maximums as well. (For example, the annual deductible for the FFS plan is 1 percent of the employee's salary for the previous year, and the maximum out-of-pocket payment is 4 percent of salary or $4,000, whichever is lower [Darling, 1991]).

Performance Reporting and Consumer Information

Consistent with Xerox's commitment to total quality management, the company works closely with the HealthLink network managers and participating HMOs to measure and improve health plan performance. Xerox has been an active supporter of NCQA and a leader in the development of the NCQA Health Plan Employer Data and Information Set (HEDIS) for measuring health plan performance. Xerox has indicated that it expects all HealthLink HMOs to obtain NCQA accreditation as one measure of health plan quality.

To assist Xerox employees in evaluating and choosing among health plans, Xerox provides each employee with an HMO performance report. This report includes comparison tables representing the characteristics and performances of all health plans in the employee's geographic area across a number of dimensions, including structure, network characteristics, access to services, member satisfaction and wait times, and HEDIS quality-of-care measures. Unlike many other examples of consumer choice information, the Xerox report card explicitly states the goals for each measure. In this way, consumers can judge how well plans are performing compared with a set of absolute benchmarks, not just plan performance relative to other plans.

Another characteristic that makes the Xerox performance report stand out is the inclusion of an explanation (in language that is understandable to typical consumers) of why each measure has been included in the report card. This builds upon the understanding that providing information to support consumer choice has an educational component. Although issues such as employee cost and whether the employee's doctor is available through the network will probably continue to be of primary salience to most consumers, performance measures and the supporting education to use those measures are expected to expand



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