Office of the Patient Advocate Releases Annual HMO Ratings
California's HMOs improved their immunization of children and management of chronic diseases over last year but did not do as well in preventive care and mental health services, according to a report released Tuesday by the Office of the Patient Advocate, the San Francisco Chronicle reports (Colliver, San Francisco Chronicle, 10/1). The third annual "Quality of Care Report Card" rated California's 10 largest HMOs based on how well they care for the chronically ill, provide preventive care, help patients recover from illness and injury, communicate with members and manage customer service (Rapaport, Sacramento Bee, 10/1). Data for the report comes from an annual study by the California Cooperative Healthcare Reporting Initiative, a voluntary collaborative of health care purchasers, plans and providers that released a longer version of the same report Tuesday, the San Diego Union-Tribune reports (Berestein, San Diego Union-Tribune, 10/1). Among the HMOs, Kaiser Permanente in Northern and Southern California and PacifiCare of California received the highest scores overall, while Aetna Health of California and Blue Cross of California received the lowest scores overall, the Contra Costa Times reports (Silber, Contra Costa Times, 10/1). For the second year, the report also rated medical groups in the state, the Orange County Register reports (Luna, Orange County Register, 10/1). The practices were rated based on their overall quality of care, timeliness of service, access to specialists and communication with patients (Sacramento Bee, 10/1). Except for the San Diego area, medical groups in Southern California generally scored lower than those in Northern California, the Chronicle reports (San Francisco Chronicle, 10/1). The report will include clinical measures for medical groups for the first time next year, the Times reports (Contra Costa Times, 10/1).
Ed Mendoza, acting director of the OPA, cautioned that consumers should not make "sweeping generalizations" from the report card, saying that people should check the specific fields they are interested in to rate both the HMOs and the medical groups, the Chronicle reports (San Francisco Chronicle, 10/1). Daniel Zingale, Governor Gray Davis' (D) cabinet secretary and the former director of the Department of Managed Health Care, said the fact that plans were not doing a good job of screening for sexually transmitted diseases, immunizing adolescents and diagnosing mental illness is "troubling." He added, "Prevention is the only way you can get the rising health care costs in control. They are failing to do a good job of that." Steve Tough, president of the California Association of Health Plans, said that HMOs take the report seriously, adding, "We need to get inside each group, and figure out how to improve scores" (Orange County Register, 10/1). Davis said, "Not only does the report card provide an annual benchmark to measure the quality of care being delivered in California, it is also a valuable tool for consumers when they are making important health care decisions" (Davis release, 9/30). While the OPA report breaks down the state by regions, county-by-county ratings of the HMOs and medical groups are also available. The OPA report is available at Walgreen's pharmacies statewide, by calling 1-866-HMO-8900 and online. The CCHRI report is available online. Note: You must have Adobe Acrobat Reader to view the report.