California To Launch Ratings for Preferred Provider Plans
The Department of Insurance on Monday plans to announce a new health care report card program for six of the state's largest preferred provider organizations as part of an effort to help consumers compare plans, the Los Angeles Times reports.
Insurance Commissioner Steve Poizner (R) said, "This is the first time in the country that ... people with PPO plans will be able to get data on how good their policy really is." Poizner said the report cards will measure how physicians in each PPO network follow best-practices guidelines, including providing childhood immunizations and giving at-risk patients regular cancer screenings.
Physicians also will be rated based on patient satisfaction surveys. The report cards also might include clinical outcomes, which could help determine how well physicians are improving care.
Poizner said details of the new reporting program were being finalized. He added that the program was the first in a series of measures he plans to take to increase oversight of the health insurance industry.
The participating insurers are:
- Aetna;
- Blue Shield of California;
- Cigna;
- Health Net;
- WellPoint; and
- UnitedHealth Group.
William Shernoff of Shernoff, Bidart & Darras, which specializes in consumer insurance cases, said, "We welcome any involvement on the part of the state to monitor the insurance industry more aggressively, which is something it has long failed to do." Shernoff added, however, "This is like a Band-Aid that won't do anything about problems like insurers denying care or pulling people's coverage for no reason" (Costello, Los Angeles Times, 8/6).
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