OPA Releases Annual Report Card
California’s Office of the Patient Advocate rolled out this week a revamped website and report card to provide ratings on health plans and medical groups.
The website, www.opa.ca.gov, was redesigned partly in response to consumer input, but also because hundreds of thousands of more Californians are expected to purchase coverage from the state-operated health insurance exchange, Healthy California, starting in October.
“We're happy to see how much more consumer friendly the website now is,” said Liz Helms, chief executive officer of the California Chronic Care Coalition, which advocates for better access to care for conditions such as diabetes and asthma.
In addition to its internal report card, the OPA website linked to six other organizations that provide quality reporting on Medicare and Medi-Cal health plans, long-term care, and ratings for plans providing care to enrollees in the CalPERS retiree system.
The OPA provided ratings for the 10 largest health maintenance organizations operating statewide, the six largest preferred provider organizations, and more than 200 medical groups. The data compiled was based on measures compiled by the NCQA. Plans and medical groups were given ratings ranging from one to four stars.
Oakland-based Kaiser Foundation Health Plan and its Permanente Medical Group dominated the scores. The HMO received four stars both for overall performance and patient experience, as well as four stars in 10 areas of providing medical care – the only plan in the ratings to do so.
Kaiser’s medical groups also received four-star ratings in a variety of regions (the OPA rated medical groups in more than 60 specific geographic regions).
All the other HMOs rated received three stars overall.
However, obtaining care easily appeared to be an issue; the plans received only one to two stars apiece.
Only two of the six PPOs rated received overall ratings of three stars; the remainder received two stars.
Among specific ratings, OPA Director Amy Krause said she was pleased with one measure in particular: The rate at which children are being immunized.
According to data compiled by the agency, HMOs and medical groups bumped up the number of adolescents are being immunized for measles, tetanus, hepatitis B and meningitis by 14%. Medical groups upped the rates by 4%. PPOs were not measured in this area.
“A 14% increase is almost unheard of in the quality measurement world,” Krause said. However, she added that there is still a lot more room for improvement in the area, noting that none of the health plans performed among the top 10% of health plans on this measure nationwide.
Krause said she was also pleased with an increase in the number of patients having their body mass index being measured.
The ratings honed in on specific care for some chronic conditions, such as diabetes. It was expanded to include ratings for testing for blood sugar and controlling for cholesterol.
However, Helms of the Chronic Care Coalition noted that the state’s health plans and medical groups still lagged behind in providing solid care to patients with chronic illness.
Not only could patients access the data from the OPA's website, but the agency introduced new applications that allow access from iPhones and iPads. Officials said an application that would work for Android smartphones and tablets was in the works.
