This is an archived article that was published on sltrib.com in 2005, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

It's that time of year when health maintenance organizations get their annual checkups. In Utah, where about 740,000 people belong to an HMO, managed-care providers managed to fall short in nearly every category of care - from adolescent immunization to cancer screenings to cholesterol control.

Collectively, Utah's five HMOs failed to meet the national standard in 34 of 39 areas, according to a statewide survey released Tuesday. The worst performer by far was Regence HealthWise (Blue Cross Blue Shield), which fell below even the statewide average in all but one category in which it submitted data.

Not all HMOs are faltering. IHC Health Plans exceeded the national average in 23 of the 39 categories and outpaced its in-state competitors in all but five. All of the state's HMOs do a blockbuster job testing and treating children with sore throats and upper respiratory infections.

Yet Utah lags behind the rest of the country in those performance areas that cut to the heart of managed care - shots and tests and office visits aimed at detecting, monitoring and treating conditions before they blossom into something more sinister and expensive. This year's report puts Utah's top insurers and their customers on notice. Such information could influence what health plans are pitched by insurance brokers and purchased by employers.

"This is the managed in managed care," said Keely Cofrin, the state's HMO health program manager and author of the 2005 Performance Report for Utah Health Plans. "And we're below the national average on 87 percent of those measures. In some cases, it's not much below, and in others, it's way below. We need to do better."

Better as in more - more mammograms, colonoscopies and checkups for Utahns age 3 through 21. But also more data. In several instances, insurers such as Regence took information only from claims and did not review medical charts because of the extra cost involved. Cigna, which insures only 3,386 HMO customers in Utah, failed to provide any information in 17 categories.

For those and other reasons, Doug Hasbrouck questions the reliability of the state survey. Hasbrouck, chief medical officer for Regence, says reporting is voluntary in most other states, and large HMOs that invest heavily in data collection tend to comply, skewing the numbers. If Regence checked charts and audited its numbers, the company would compare favorably, he said, but the cost would have to be divided among a relatively small number of clients. Only 9 percent of Regence customers are enrolled in managed care.

"To spend the money to prove that point doesn't make sense to our customers who are concerned about the price of their health insurance," Hasbrouck said.

Added Regence spokesman Kevin Bischoff: "Our products are based on a big network and lots of benefit choices, and an HMO is kind of the opposite of that. However, for those people who do want an HMO, we do provide one and we want it to be a good HMO."

If good health is the measure of a good HMO, then Regence is succeeding. According to the statewide study, 68 percent of HealthWise customers rate their overall health as excellent or good - the most of any HMO in the state. However, the company received only average marks in all other consumer satisfaction categories, from claims processing to customer service to rating of their health plan. Altius received the best grade in the latter category and United HealthCare was ranked lowest. United did not return a phone call for comment.