Online Update

QUALITY CARE
Warm and fuzzy doesn't mean best

While patients may prefer the "personal touch" of small neighborhood doctors' offices, integrated medical groups generally provide higher-quality care, according to an article in the Dec. 5, 2006 issue of Annals of Internal Medicine. Using data from a California HMO's quality report card, researchers compared the quality of care delivered by 119 integrated medical groups and IPAs. They looked at six HEDIS standards. The IMGs, with employed physicians practicing together in facilities owned and managed by the group, scored higher than the IPAs on four of the measures—screenings for cervical and breast cancer, chlamydia infection, and diabetic retinopathy.

Researchers speculate that centralized decision-making and the closer affiliations of the integrated groups might enable them to provide higher-quality care, at least for the types of medical services measured by the HMO's performance reports. In addition, they suggest that these groups may have more resources to invest in improving care and that younger doctors with the latest training might also be more likely to join them.

RETIREMENT
Are fees crushing your returns?

Investors are putting more money in 401(k) plans, but they can't easily figure out how much they're paying in fees, says a Government Accountability Office study. Participation in 401(k) plans rose from less than 8 million investors in the mid-1980s to about 47 million in 2005, with assets rising 20-fold, to more than $2 trillion. But plan sponsors distribute information in a scattershot fashion, forcing investors to sift through various documents to learn how much they're paying in fees. And those fees are important, because they eat away at retirement savings. According to the GAO, a 1 percentage point difference can cut investment returns by 17 percent over 20 years in a typical retirement scenario.

HEALTH COSTS
The three R's add up to savings

Encouraging youngsters to stay in school might help lower the nation's healthcare bill, says the Alliance for Excellent Education, a Washington, DC-based advocacy group whose mission is to have every child graduate. The Alliance argues that higher educational attainment improves a student's future income, occupational status, and social prestige, which contributes to improved individual health. Researchers estimate that the US could save $17.1 billion if every student in the class of 2005-2006 graduates from high school. They arrived at that figure by combining the lifetime costs of Medicaid and expenditures for uninsured care, then multiplying the total by the number of students who drop out of the nation's high schools. Alliance President Bob Wise says the study clearly shows that a high school diploma opens the door to physical as well as financial health.

TRAVEL
Lots of points, but nowhere to fly

The number of airline seats available for frequent flier redemptions has dropped by an average of 11 percent since 2000 for six major carriers, says the inspector general for the Department of Transportation. At the same time, airlines are offering more ways to earn points, such as with credit card purchases, which is serving to lessen the value of each accumulated mile. To make matters worse, consumers can't effectively compare frequent flier programs because information on redemptions is difficult to find and virtually impossible to compare across airlines.

REAL ESTATE
Where the living is free and easy

Tired of feeling on edge all the time? Then head for St. George, Utah, which is ranked the most secure town in the country by Farmers Insurance Group. The small city (population 104,000) got the highest spot in the third annual "Most Secure U.S. Places to Live" survey on the basis of crime statistics, job losses, weather, natural disasters, environmental hazards, and terrorism threats. The safest large city with 500,000 residents or more is the Boise-Nampa area in Idaho, while Las Cruces, NM, is the safest mid-size city.