SOURCE: Office of the Patient Advocate

Office of the Patient Advocate

February 09, 2010 13:30 ET

New Ratings on HMO and Medical Groups Released by State of California Show Increase in Patient Satisfaction

Officials Unveil First-of-Its-Kind Online Tool to Compare Health Plans

SACRAMENTO, CA--(Marketwire - February 9, 2010) - Six out of the nine largest HMOs showed improvement in their patient satisfaction ratings in the state of California's 2010 Health Care Quality Report Card. At the same time, California continues to lag on some critical indicators of good care according to the California Office of the Patient Advocate, which released the annual Report Card today. The Report Card rates the nine largest commercial HMOs in the state which cover nearly half of all Californians.

"I am encouraged to see that more health plan members are satisfied with the services from their health plans than last year," said Office of the Patient Advocate Director Sandra Perez. "It's critical that Californians have the information and tools available to receive the best value for their health dollars. This information is also helpful to the health plans in their efforts to improve the services and programs that they offer."

Specific findings in the 2010 Edition of the Health Care Quality Report Card include:

--   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
--   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,, 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,

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 Copies of the Report Card can also be obtained by calling 1(888) 466-2219.