PACIFICARE: Receives ‘Blue Ribbon’ Award From PBGH
PacifiCare Health Systems Inc. is this year's recipient of the Pacific Business Group on Health's Blue Ribbon HMO Award. The designation recognizes the HMO's high performance in the areas of quality, cost, data and partnering. PBGH said PacifiCare ranked highly in efforts to partner with providers and scored above average on several commercial and Medicare preventive care services.
By Any Measure
In the area of quality, PacifiCare received full 3-year accreditation from the National Committee on Quality Assurance, and the HMO introduced a " quality index" that ranks the relative performance of PacifiCare's contracting medical groups in the state. Patricia Powers, executive director of PBGH, said, "PBGH applauds their leadership in taking this important step in measuring provider performance. It is a stepping stone towards establishing marketwide standards and quality metrics for evaluating provider-level performance, similar to what we have all accomplished for health plans." In the area of cost, PacifiCare was recognized for its multi-year agreement with PBGH's Negotiating Alliance and CalPERS in 1998. Teddy DeRivera, vice president of PBGH-member Wells Fargo Bank, said, "Multi-year agreements are crucial to maintaining rate stability for purchasers. Long-term pricing arrangements enable employers and plans to invest in programs to improve disease management and information systems." PBGH is recognizing PacifiCare in the area of partnering for the HMO's leadership in collaboration with purchasers and providers. For the second year in a row, PBGH's Physician Group Survey to Assess HMO Performance ranked PacifiCare as one of the top two plans, with high marks for data reporting and referral management issues.
Improvement All Around
PBGH reported that several other plans improved in the areas of quality and data over the past years. But Michele French, director of health and welfare benefits at the University of California, said that "there is still significant room for continued improvement." She added, "Purchasers do not see true excellence being demonstrated, even among the highest scorers. Our goal is to see the entire performance curve advance over time" (PBGH release, 9/17). Performance scores of specific plans can be accessed at PBGH's consumer information website -- www.healthscope.com. To learn more about PBGH, visit the group's website at www.pbgh.org.