Oct. 08--Kaiser Permanente was the highest-rated HMO and Anthem Blue Cross and Cigna the top-rated PPOs in a new state report.
The California Office of the Patient Advocate released ratings Wednesday of 10 HMOs, six PPOs and more than 200 medical groups, just as Californians prepare to choose their health plans for next year from their employers or Covered California, the state's Obamacare exchange.
The reviewed health plans provide coverage to more than 16 million California residents. They were graded on their ability to meet standards in several areas, including many types of preventive care such as screenings for cancer, high blood pressure or high cholesterol.
Kaiser's Southern California and Northern California units were the only HMOs to receive four-star ratings.
"This rating is another acknowledgment of the high-quality care Kaiser Permanente clinicians and staff provide every day," Kaiser Permanente spokesman John Nelson said in an email to The Times. "We encourage consumers to review independent quality ratings like these, so that they can be better informed and even more engaged in their care."
The ratings are available at the patient advocate's website: www.opa.ca.gov.
Elizabeth Abbott, director of the state patient advocate office, said the report was issued to help Californians make informed decisions as they choose their coverage for 2016. Open enrollment for Covered California begins Nov. 1 and continues through Jan. 31. The state exchange also provides a mechanism for judging the quality of health plans.
"We're trying to add the quality measure to the equation so employers and unions and consumers will make real solid informed decisions," Abbott said.
In addition to the overall grades, the state provided ratings of the plans' performance in several specific areas, including maternity care, cancer detection, diabetes care and heart care. The breakdowns would allow a couple expecting a child next year to see which plan received the highest mark for maternity coverage. (Among the HMOs, Kaiser received four stars, while Aetna received just one.)
This is the 15th year that the state agency has released the ratings. Until recent years, the reports were released in January. The agency moved the release date to October in order to help consumers decide which plan to choose during open enrollment, Abbott said.
Many consumers are demanding more information on healthcare quality as they face rising deductibles and are forced to take on a bigger share of their medical costs.
The state report card does not review costs, but that's something the agency may include in the future, Abbott said.
stuart.pfeifer@latimes.com
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