Office of the Patient Advocate Releases 2018 Health Care Quality Report Cards

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Office of the Patient Advocate Releases 2018 Health Care Quality Report Cards

New five-star rating system helps Californians make informed decisions when choosing a health plan.

(Sacramento) — During open enrollment, millions of Californians make important choices regarding their health care. Today, the Office of the Patient Advocate (OPA) released the 2018-19 edition of its Health Care Quality Report Cards, an online tool to help Californians make informed decisions when choosing a health plan.

This year, a new 5-star rating system is used to rate California’s ten largest Health Maintenance Organizations (HMO), six largest Preferred Provider Organizations (PPO), and over 200 commercial medical groups on clinical quality and patient experience. In 2017, nearly 14 percent of commercially insured Californians enrolled in five-star groups, and over 50 percent enrolled in groups rated four-stars or higher.

The Report Cards provide consumers ratings on patient experience measures related to getting care easily, satisfaction with plan doctors and services, and communication between doctors and patients. The Report Cards also offer an assessment of health plans and medical groups who are especially effective in diagnosing and/or treating different health conditions. Consumers can compare health plan performance on various measures, such as:

  • Providing preventive screenings for cancer
  • Checking if weight gain could cause health problems in both children and adults
  • Controlling blood pressure and blood sugar for diabetic patients
  • Ensuring follow-up visits after a hospital stay for mental illness

OPA’s efforts to publicly report data and advocate for consumer interests is made possible by help from its partners, including the National Committee for Quality Assurance (NCQA), the Integrated Health Care Association (IHA), the American Institutes for Research (AIR), and the Pacific Business Group on Health (PBGH).

The report cards are available online at www.opa.ca.gov.

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