The nation's biggest health insurers have taken to rating hospitals on quality and cost, saying the information can help patients make better choices.
Now, hospitals are giving insurers a dose of their own medicine.
A survey of hospital executives to be released Thursday found that some national insurers have their own image problems.
Three of the nation's five largest insurers had higher negative approval ratings than positive ones, according to the survey. UnitedHealth Group Inc., which has contracts with 96 percent of the hospitals responding to the survey, generated the worst ratings.
Minneapolis-based United received an "unfavorable" opinion from 91 percent of the hospital executives who responded, while 8 percent gave it a "favorable" rating. United owns California's PacifiCare.
United has proposed a $2.6 billion acquisition of Sierra Health Services Inc., based in Las Vegas. That merger has raised concerns from Gov. Jim Gibbons and several members of the Legislature.
Indianapolis-based WellPoint Inc., which owns Blue Cross of California, was second worst with 48 percent unfavorable and 20 percent favorable. Cigna received a 47 percent unfavorable rating and 44 percent favorable rating.
Aetna earned the best score with 57 percent favorable and 37 percent unfavorable ratings. Insurers also having overall favorable ratings were Coventry/First Health and regional insurers rated as a group.
United refuted the findings and its methodology.
"UnitedHealthcare ranks above the industry regarding claims payments," said spokesman Tyler Mason, adding that it pays 95 percent of claims within 10 days. "Our goal is to work directly and collaboratively with hospitals to decrease administrative cost and complexity so that hospitals receive fair compensation for services at the same time balancing the overall health-care cost in line with the consumer price index on behalf of our members."
A spokeswoman for WellPoint said the company was reviewing the survey and said it takes it upon itself to stay abreast of hospital executives' opinions through its own surveys.
Jan Emerson, a spokeswoman for the California Hospital Association, said the survey confirmed "what we are hearing from a lot of our member hospitals about health plans that operate in California, particularly the two largest ones, United and WellPoint."
Davies Public Affairs, a Santa Barbara, Calif., company that represents some hospitals, commissioned the survey. It was conducted by Fabrizio, McLaughlin & Associates, Inc., a polling company whose clients include politicians, corporations and the American Insurance Association. The results are based on interviews with 113 executives representing more than 500 hospitals, or 10 percent of all hospitals, in 44 states.
The findings could help consumers shop for coverage, said Brandon Edwards, Davies' chief operating officer.
"It's definitely a wake-up call for the employers," Edwards said. "When you pick a health plan for your employees, think very hard about what the health plans' relationships are with their primary providers."