DMHC Issues Report Cards Rating HMO Services
California HMOs are "generally" doing well in fostering doctor-patient communication, but are not faring as well in providing health services such as chronic care treatment, according to new HMO report cards issued today by the state Department of Managed Health Care (Colliver, San Francisco Chronicle, 9/24). The AP/Contra Costa Times reports that the new report cards rated 17 HMOs serving 20 million Californians on 57 indicators "grouped into five categories: "wellness care, treating acute illnesses, dealing with chronic illnesses, doctor communication and service, and service from the HMO itself." Kaiser Permanente of Southern California was the only health plan to earn high marks in all five categories, while five other HMOs did well in four categories. All 17 HMOs -- which participated in the survey voluntarily -- earned "high ratings for most indicators" of the quality of physician-patient relationships, and scored the worst in the treatment of chronic conditions, mental illnesses and sexually transmitted diseases (Keith, AP/Contra Costa Times, 9/24). Discussing the report, which graded the health plans in each category using a zero- to three-star system, DMHC Director Daniel Zingale said, "These are not movie ratings. A missing star could mean a missing surgeon, a missing hospital bed or life-saving drug. Where there are missing stars, those are serious issues for people." The reports cards will be available later today on the DMHC Web site at http://www.hmohelp.ca.gov/.
A separate survey of California HMO members finds that 87% of respondents "said their physician listened to them carefully," but about one in four said they "had to wait more than a half hour beyond their scheduled appointment" (San Francisco Chronicle, 9/24). The Consumer Assessment Survey of 21,104 members in four HMOs -- Blue Cross of California, Blue Shield of California, Health Net and Kaiser -- and 59 medical groups conducted jointly by the Pacific Business Group on Health and the California Cooperative Healthcare Reporting Initiative found that 31% of consumers said that getting treatment or tests they believed necessary was a "problem," while 38% said they had difficulty seeing a specialist. However, 67% of respondents rated the care they had received in the past 12 months as "very positive." Overall, medical groups in the northern part of the state received higher marks than those in Southern California (Pacific Business Group on Health, 9/21). The Consumer Assessment Survey is available at http://www.healthscope.org/.