title: An opportunity for HMOs to use marketing to increase enrollee satisfaction.
abstract: OBJECTIVE
  To identify the combination of marketing components (i.e., service, price, access, and promotion) of commercial health maintenance organizations (HMOs) that are related to overall enrollee satisfaction. The researchers focus on factors that commercial HMOs control directly--specifically, health care organization and financing.
  
  
  METHODS
  Descriptive (mail order).
  
  
  METHODS
  This study uses national data provided by a major health benefits consulting firm, which collected data from a 1997 calendar year mail survey of HMO administrators. The administrators responded to an extensive survey, which tapped selected HMO marketing-mix components and the percentage of surveyed members who indicated satisfaction with their HMOs. To test hypotheses, researchers treated marketing-mix components as independent variables and enrollee satisfaction as the dependent variable.
  
  
  RESULTS
  This study found statistically significant relationships between overall satisfaction and HMO providers' quality; access, particularly to specialists and out-of-network providers; waiting times for physician services; customer service; and disease prevention/health promotion programs. The researchers did not find significant relationships between overall satisfaction and accreditation by the National Committee for Quality Assurance (NCQA), the presence of physician gatekeepers, numbers of providers, or financial indicators. The relationship between overall satisfaction and utilization was mixed. This study's findings are largely consistent with the literature, consumer- and professional-group position papers, and the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry.
  
  
  CONCLUSIONS
  HMOs can use marketing as a way to address problems and pursue opportunities identified by enrollees. As these findings demonstrate, certain features of HMO design are more appealing to patients. By focusing on these preferences, HMOs can adopt a responsive market orientation that gives rise to more effective marketing mixes and hence improves enrollee satisfaction. With improved satisfaction, enrollees generate less need for government intervention through regulation or legislation.
authors.affiliation: College of Health, University of Utah, 250 South 1850 East #215, Salt Lake City 84112-0920, USA. Richard.Dwore@health.utah.edu
authors.forename: R B
authors.initials: RB
authors.lastname: Dwore
authors.forename: B P
authors.initials: BP
authors.lastname: Murray
authors.forename: R P
authors.initials: RP
authors.lastname: Parsons
authors.forename: G
authors.initials: G
authors.lastname: Gustafson
mesh_terms: D003625:Data Collection; D019538:Health Care Surveys; D006270:Health Facility Administrators; D006279:Health Maintenance Organizations / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D006293:Health Promotion; D006297:Health Services Accessibility; D006801:Humans; D008389:Marketing of Health Services / Q000145:classification / Q000379:methods*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011314:Preventive Health Services; D011787:Quality of Health Care; D014481:United States; D014850:Waiting Lists