Israelis can now learn which health care maintenance organizations tend to carry out which tests, after a judge last year ordered that this information be broken down.

Last May, Judge Moussia Arad, president of the Jerusalem District Court, ordered the publication of data comparing the four HMOs, following a petition by the Movement for Freedom of Information. The group demanded that the data be broken down according to HMO, to augment the overall national data.

 

The report was carried out by the Israel National Institute for Health Policy and Health Services Research, which collected the numbers for the Health Ministry using experts from the Hebrew University of Jerusalem.

 

For example, Maccabi Healthcare Services is Israel's leader in vaccinating seniors against the flu and performing mammograms for women over 50, while Clalit leads in hemoglobin tests to detect anemia among babies. It also leads in tests to detect children liable to become obese.

In recent years, the HMOs have been targeting older patients, urging them to be vaccinated against the flu and to have tests for the early detection of cancer.

 

According to data from 2008 to 2010, Maccabi led in mammograms among women above 50. Among Israelis between 50 and 59 who earned enough to pay health tax, 70.8 percent were screened at Maccabi, 69.3 percent at Clalit, 66.6 percent at Meuhedet and 51.5 percent at Leumit.

For women between 61 and 68, Clalit led with 74.2 percent (over Maccabi with 73.8 percent ), but among women exempted from paying health tax, Maccabi led Clalit at 71.1 percent to 69.9 percent. For women between 69 and 74, both Maccabi and Clalit screened 68.1 percent of members.

Maccabi also led in vaccinating seniors against the flu. For patients between 65 and 73, among payers of the health tax, Maccabi reached 59.4 percent, Meuhedet 56 percent, Clalit 53.3 percent and Leumit 39.6 percent. Maccabi led Clalit among patients over 74, but Clalit led Maccabi among women of that age.

For the early detection of colorectal cancer by fecal occult blood testing, Clalit led among payers of the health tax between 50 to 59 (men 41.8 percent, women 46.6 percent ), while Meuhedet led among non-health-tax payers (men 38.9 percent, women 45.7 percent ).

Clalit has a significant lead in hemoglobin texts for detecting anemia among infants. Clalit tested 89.5 percent, Leumit 72.3 percent, Meuhedet 69.2 percent and Maccabi 58.6 percent.

Clalit has a huge lead in tests for 7-year-olds for the early detection of the tendency to become obese.

In cholesterol tests for patients between 35 and 44, Maccabi leads by a small margin among men, while Clalit leads by a small margin among women.

All four HMOs scored relatively low ratings for eye tests among diabetes patients in danger of deteriorating eyesight. For the ages 25 to 34, Clalit tested 55.3 percent of male diabetes patients, Meuhedet 45.8 percent, Maccabi 44.5 percent and Leumit 33.5 percent. For women, Clalit tested 58.5 percent, Maccabi 50.7 percent and Meuhedet 46.3 percent.

All four HMOs did well in treating asthma suffers between 5 and 9, with Meuhedet leading among boys and Leumit among girls.

The report shows that 0.7 percent of Israelis suffer from asthma that can be treated by medicine, while 5 percent suffer from diabetes, a percentage that is rising 0.25 percentage points annually.

In 2007, the Movement for Freedom of Information already requested data for 2006 but was refused by the Health Ministry, which said this was privileged information based on laws on patients' rights. The ministry later said it didn't possess the comparative data, but Judge Arad rejected these claims and ordered the publication of the numbers.

The report's authors say a similar document in the United States last year shows that even though publication of comparative data is meant largely for patients seeking to choose their health coverage, the main beneficiaries are the HMOs themselves.

Deputy Health Minister Yaakov Litzman, meanwhile, said future reports would include data on waiting periods and access to treatments at the various HMOs.

Israelis rarely switch from one HMO to another. At the end of 2011, more than half the insured were Clalit members (52.5 percent ), Maccabi had around a quarter (24.8 percent ), Meuhedet 13.5 percent and Leumit 9.2 percent.

To switch from one HMO to another, Israelis must pay NIS 15; this is possible on six fixed dates throughout the year. Last year, only 1.3 percent of Israelis moved from one HMO to another.