Officials Unveil First-of-Its-Kind Online Tool to Compare Health Plans
-- For the first time, some health plans received four-out-of-four stars for patient satisfaction. Kaiser Permanente Southern California, PacifiCare and Western Health Advantage all received four-star ratings from their members. -- Kaiser Permanente Southern California is the first HMO health plan to receive four stars in both meeting national standards of care and member satisfaction. -- Three HMOs -- Aetna Health of California, Anthem Blue Cross and Cigna HMO -- showed improvements in both meeting national standards of care and member ratings. -- The ratings of the other three HMOs -- Blue Shield of California HMO, Health Net of California and Kaiser Permanente Northern California -- remained the same."This year's Report Card shows some overall improvement in clinical care, but also highlights specific areas where health plans need to provide better care," said Perez. "For the 18 million Californians who rely on HMOs for their health care, knowing how their health plan rates on various indicators will help them make better health care decisions." Areas needing improvement in the screening and/or treatment of certain health conditions include:
-- Colorectal cancer screening rate has seen strong improvement in the past five years, but the absolute rate is still 57 percent. -- Chlamydia screening has also seen significant increases over the past five years, but the average rate is still only 40-50 percent. -- Almost 50 percent of commercially-insured children continue to wrongly receive antibiotic drugs for conditions such as sore throats, for which these medications don't work. -- About 60 percent of patients needing continuous mental health services receive that follow-up care.Areas where clinical data measures show improvements:
-- Screening tests (blood sugar) for patients with diabetes have shown steady improvement over the past decade and now average about 90 percent. -- Cholesterol screening rates of patients with cardiovascular disease have also steadily increased and now average about 90 percent.To help make it easier for Californians to choose a health plan and maximize the care they receive, the Office of the Patient Advocate introduced an innovative new feature on its Web site, opa.ca.gov, which allows consumers to compare health plans based on what they offer and how they rate in key areas. The new 'Compare Health Plans' feature, the first of its kind, allows consumers to compare the health services and programs that plans provide in four categories of programs or services that help health plan members: 1) get fit and stay well; 2) take care of a health problem (addressing 15 different health conditions); 3) use a personal health record; and 4) learn rules to see doctors. This new tool provides Californians even greater information when choosing the best health plan for themselves and their families. In addition to the annual Report Card, the Office of the Patient Advocate offers other resources to help Californians get the most out of their health care. These include health worksheets on making the most of doctor visits, a guide on how to use your health plan, information on patient's rights, and instructions for reporting problems or complaints with your health insurance plan. All of these resources can be found on the Office of the Patient Advocate Web site, opa.ca.gov. The Office of the Patient Advocate is an independent office in state government that informs Californians about their rights and responsibilities as health plan members and teaches them how to get the most out of their health care. For more information about the Health Care Quality Report Card or to see the detailed ratings, visit opa.ca.gov. Copies of the Report Card can also be obtained by calling 1(888) 466-2219.