Satisfaction with HMOs. Accessibility issues top the list for patients in commercial groups.

Most complaints about HMOs fall into three broad categories: quality of care, provider attitude, and accessibility to care. Of these, marketers should focus their efforts on the latter. Ensuring that subscribers understand their benefits can help reduce expectations and, therefore, dissatisfaction. Even though accessibility to care (as covered benefits) was very important in contributing to survey respondents' satisfaction with their health care, overall satisfaction did not affect a patient's decision to change physicians and only marginally affected the decision to change HMOs. In the member/provider relationship, the primary care physician may represent a barrier to benefits because he or she has the power to control access under the HMO structure.