HMO Plans Nab High Scores for Care, but Struggle on Access
Many California residents gave their HMO plans good or excellent scores for providing health care but assigned lower scores for the plans' access to care, according to a statewide report card from the state Office of the Patient Advocate, the Ventura County Star reports.
Report Card Details
The annual report card scores HMO and PPO insurance plans that cover a total of 16 million California residents (Kisken, Ventura County Star, 3/27).
It ranks health plans depending on how well they meet 40 quality measures (Kleffman, Contra Costa Times, 3/28).
HMO Scores
Of the 10 HMOs included in the report card, none received scores of less than "good" for delivering health care to patients.
HMOs that received overall scores of "excellent" for care delivery were:
- Kaiser Permanente in Northern and Southern California;
- Sharp Health Plan; and
- Western Health Advantage (Ventura County Star, 3/27).
However, none of the 10 HMOs received "excellent" or "good" scores for access to care. Seven HMOs received scores of "poor" for patients' ability to access care easily (Terhune, Los Angeles Times, 3/27).
HMOs that received the highest scores of "fair" for access to care were:
- Blue Shield of California;
- Kaiser Permanente Northern California; and
- Western Health Advantage (Ventura County Star, 3/27).
PPO Scores
Of the six PPOs included in the report card, Cigna and United Healthcare received scores of "good" for providing health care to patients. All other plans received a "fair" score for delivering care (Office of the Patient Advocate report card, March 2013).
Meanwhile, PPOs largely scored better on access to care than HMOs. Both Anthem Blue Cross and Blue Shield of California received scores of "good" for access to care (Ventura County Star, 3/27). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.