HMOs Make Few Gains in Patient Care in Annual State Report Card for Consumers

In a California Healthline Special Report, John Zweifler of the state Office of the Patient Advocate, Aetna spokesperson Rochelle Cunningham, California Medical Association President Anmol Singh Mahal and Elizabeth Abbott, project director for Health Access, discussed results of the OPA’s annual Healthcare Quality Report Card on HMOs and physician groups.

The report card found that HMOs have not made significant gains in patient care quality over last year, falling short in treatment for asthma, diabetes and obesity.

Zweifler said the report card increases accountability and competition among providers, which can improve quality.

However, Cunningham said Aetna — which received the report’s lowest ratings — believes the report card oversimplifies complex consumer data.

CMA also has criticized the report’s methodology. Mahal said, “We feel that it was inappropriate that doctors, nurses and other caregivers … were not consulted in terms of our analysis of the HMO performance.”

Abbott said that a consumer-oriented report card is a good first step but that the ratings should focus more on the state agencies and employers who contract with insurers to purchase health care (Kennedy, California Healthline, 10/29).

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