State issues report cards for HMOs, PPOs and large medical groups

October 16, 2015
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement Public Payors 

The California Office of the Patient Advocate (OPA) recently released its 15th annual “California Health Care Quality Report Cards,” which rates the state's health plans and medical groups on a four-star scale.

Available in English, Spanish and Chinese, the report cards allow consumers to compare the quality of care that more than 16 million commercially insured consumers receive from the state’s 10 largest HMOs, six largest PPOs and more than 200 medical groups. The data for the report cards is drawn from claims data and patient surveys from 2013.

Users can drill-down online to see specific plan performance on topics of greatest interest to them, such as chronic disease management, pediatric care and mental health care.

The report cards have been released to coincide with the fall open enrollment period for many Californians and their families, including those purchasing coverage through Covered California, the state's health benefit exchange. Covered California's next open enrollment period runs from November 1, 2015, to January 31, 2016. The report cards are part of a larger national push to bring greater transparency to the health care industry and help consumers choose services that best fit their needs.

The report cards are available at the Office of the Patient Advocate's website



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