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Health Plans

Friday, March 11, 2011

California HMOs Score Well for Meeting Care Quality Standards

Most large HMOs in California received high marks for overall quality of care and patient satisfaction, but some health plans still fell short in certain areas, according to the state's 2011 Health Care Quality Report Card, the Sacramento Bee reports.

For the latest report card, California's Office of the Patient Advocate rated the state's nine largest HMOs (Glover, Sacramento Bee, 3/11). Ratings were based on consumer survey responses and reviews of policyholders' records.

OPA rated the plans on a four-star scale for various measures, with one star representing a "poor" score and four stars representing an "excellent" score (Mohajer, AP/San Francisco Chronicle, 3/10).

Quality of Care

For the third consecutive year, Kaiser Permanente was the only health plan to receive a four-star rating for meeting national standards on quality of care. Both Kaiser's Northern California and Southern California HMOs received the top rating.

The HMOs that received a three-star rating for meeting national quality of care standards are:

  • Anthem Blue Cross;
  • Blue Shield;
  • CIGNA;
  • Health Net;
  • PacifiCare; and
  • Western Health Advantage.

Aetna received two stars for quality of care.

Other Categories

For a category based on member ratings for plan service, OPA gave:

  • Three stars to Aetna and Western Health Advantage; and
  • One star to Kaiser Permanente Northern California.

For a category on the ease of obtaining care, the report card gave:

  • Two stars to Kaiser Permanente Northern California and Western Health Advantage; and
  • One star to the remaining seven HMOs evaluated.

In comparison with previous years, OPA noted that California's HMOs had made improvements in ensuring the accuracy of prescriptions for asthma medications. OPA also noted that HMOs performed well for testing blood sugar and cholesterol levels for patients with diabetes.

The office said HMOs should work to improve their performance in measuring the body mass index of children and adults to evaluate risks for obesity and weight-related health problems (Sacramento Bee, 3/11).

Broadcast Coverage

On Thursday, KPBS' "KPBS News" reported on the scores in the health plan report card (Goldberg, "KPBS News," KPBS, 3/10).



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