The Medicaid HMO plans best national averages for all consumer satisfaction measures, for childhood immunizations and infant well-child visits, for prenatal and postpartum care. They are at the national average in terms of breast and cervical cancer screenings.

The CHIP HMOs top national averages in all consumer satisfaction measures except customer service. They lag behind the averages for well-child and primary-care visits for children 3-6 and adolescents.

The report comes with some explanations, such as that plans have different ways of collecting data. Some do chart reviews to back up their data codes, and those reviews tend to raise the ratings, Cofrin said.

Kathleen Murphy, spokeswoman for Regence, which runs HealthWise, said that HMO has been closed to new participants for three years and doesn't provide an apples-to-apples comparison to other HMOs because members need not have a primary-care physician or go through a gatekeeper to see a specialist, but four survey categories relate to primary-care services and such referrals.

David Larsen, SelectHealth director of quality, said his company keeps improving in areas highlighted in the report. For instance, he said, they contact plan members who are over 50 and have not been screened for colorectal cancer — a reminder and an offer of more information. Analysis shows it has improved the screening rates. They have similar programs for hypertension, diabetes, cholesterol management, women's health and childhood and adolescent immunizations.

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