TRENTON, N.J., October 18 – Seven of ten customers said they had no problem in getting assistance from their health maintenance organizations last year, according to the results of the 10th annual report card on HMO performance. The results on the eight major HMOs were released by the state Insurance Department.

Insurance Commissioner Steven Goldman said the survey showed that the health insurers made progress in several areas but there is room for improvement.

On the plus side, the survey showed that three-fourths of respondents had no trouble in seeing a doctor, but on the flip side, only 47 percent reported that their HMO handled claims promptly and correctly.

Further, only 36 percent said they would rate their HMO a 9 or 10.

Aetna Leads the Way

According to the report, only 31 percent of CIGNAs customers rated it a 9 or 10, and only 33 percent gave a high rating to Horizon Blue Cross/Blue Shield.

Aetna got high marks from 57 percent of the respondents; Oxford 53 percent; WellChoice 43 percent; AmeriHealth 39 percent; United 33 percent; and HealthNet 31 percent.

A department official said HMOs did better in eye exams for diabetes patients (up four percent), childhood immunization (up three percent), and anti-depressant medication management (up three percent).

The department official said in individual plan performance, CIGNA, Oxford, and United Health reported declines in five or more of the clinical performance measures, with each reporting deceases of at least six percent for one or more measures.

It was also reported that Horizon, WellChoice, and AmeriHealth all had mixed performances, with more improvements than declines.

The report is based on opinions of 11,300 customers in the plans, plus data compiled by the HMOs. It marks the first year that the Insurance Department issued the report. Previous reports were compiled by the Health Department. A year ago, the functions of the Office of Managed Care were transferred from the Health Department to the Insurance Department.

The detailed report is on the departments website.