Report Card Ranks State HMOs

Kaiser Permanente's Northern California division was rated as "excellent" in three categories in an annual state HMO report card, more than any of the other HMOs evaluated, the Contra Costa Times reports (Kleffman, Contra Costa Times, 9/28). The 2006 Healthcare Quality Report Card included information on nine HMOs accounting for about 95% of HMO enrollees in California.

The Office of the Patient Advocate produces the report annually (Hagedorn, Bakersfield Californian, 9/28). The rankings are based on reports HMOs submit to the National Committee on Quality Assurance and surveys of HMO members and physician groups (Chan, Sacramento Bee, 9/28).

The report evaluates HMOs in the following categories, based on more specific measures:

Asthma treatment;
Cancer screenings;
Cardiac care;
Diabetes management;
Maternity care;
Mental health care;
Screening for sexually transmitted infections; and
Treating infections and providing immunizations to children.

Ed Mendoza, deputy director of OPA, said the criteria were raised in this year's report, with HMOs having to rank among the top 1% of plans nationwide to receive an "excellent" rating (Goldeen, Stockton Record, 9/28).

To receive an excellent rating, 80% of patients must have received care consistent with recommended treatment guidelines or reported a favorable experience with the HMO. Plans received "poor" rankings if fewer than 60% of patients received recommended care or reported positive experiences (Allday, San Francisco Chronicle, 9/28).

Dr. John Zweifler, a medical consultant to OPA, said that over the past year HMOs improved notably in:

Examining diabetic patients' eyes;
Screening for chlamydia; and
Treating hypertension.

However, the Sacramento Bee reports that HMOs' performance declined in:

Breast cancer screenings;
Follow-up mental health care;
Smoking cessation advice; and
Treatment of throat and upper respiratory infections in children (Sacramento Bee, 9/28).

The report also rated medical groups (Correa, Fresno Bee, 9/28). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.