California Issues Annual ‘Report Card’ Rating Insurance Plans in the State
Today, California’s Office of the Patient Advocate released its annual report card rating some of the state’s most popular health insurance plans and companies. Included in the report were California’s nine largest HMOs, six largest PPOs, and 212 medical groups.
According to an article and accompanying image by Sandy Kleffman of the Bay Area News Group, the HMOs and PPOs were given one to four stars on several factors, such as how well the quality of care met national standards, customer service, asthma care, and care for other specific health conditions. For insurance plans, ratings were based on member experiences and clinical quality measures. For the medical groups that worked with these insurance plans, ratings were based on patient experiences and clinical quality measures, and were sorted by county.
The results were mixed, writes Ms. Kleffman. For example, the state’s insurance plans have become better at caring for diabetes patients, a change that could be attributed to previous report cards, which identified diabetes care as a problem area. Now, the state’s plans exceed national standards on most diabetes care measures. On average, they have also improved at controlling high blood pressure and cholesterol, writes Chad Terhune of the Los Angeles Times.
OPA hopes for similar improvement in care for more health conditions identified by the report, for which California failed to meet national standards. Among them are flu shots for adults, care for children with ADD, treatment for substance abuse, and testing for lung disease. According to OPA director Sandra Perez, quoted in Mr. Terhune’s piece, releasing the report card data publicly will urge providers to improve their quality of care and health plans to change their policies.
Customer service was also lacking, the report found. All but one of the health plans that were rated scored one or two stars in this category, which included unexpected costs, accuracy of claims, and resolution of complaints.
Readers, how would you rate your insurance plan? What factors do you consider most important?
Posted on Wednesday, February 22nd, 2012 at 1:05 pm. You can subscribe via RSS 2.0 feed to this post's comments. You can comment below. Your comments will appear immediately, but the author reserves the right to delete innapropriate comments.