Tip: If the health plan collects consumer satisfaction surveys, find out if they sample people who have special health problems separately. In general, most health plans have relatively high member satisfaction levels. But these numbers may not be a good indication of the experiences of people with special health care needs. Most HMO enrollees, and consequently, most of the people who respond to the member satisfaction surveys, are relatively healthy. An enrollee who is healthy and rarely uses health services will have fewer interactions with the HMO, and thus are likely to have fewer problems within the system.

Tip: The NC Department of Insurance collects and reports data on the number of individuals and groups that withdraw from a health plan, as well as the numbers of providers who left a plan voluntarily and involuntarily. This report is called "Managed Care Handbook: Comparison Guide for North Carolina Consumers" and can be ordered at 1-800-622-7777 or 1-800-546-5664. The Guide is also available through the internet at: www.ncdoi.com.

People may leave health plans for a variety of reasons. For example, a health plan may have raised its premiums, forcing an employer or individual enrollees to choose a lower-cost plan. An HMO may stop covering a particular part of the state, forcing some enrollees to choose another plan. Doctors may leave the plan because they are unhappy with the HMO’s reimbursement rate. So, disenrollment numbers, by themselves, should be read with some caution.