In Brief: Covered California Releasing Ratings; Rural ACO Formed

Covered California Releases Health Plan Ratings

The Covered California health insurance exchange has released a quality ratings system for the plans being offered to consumers.

The system is based on one to four stars. Those with four stars are in the highest 25% of all health plans. Those with three stars are in the 50 to 75 percentile. Those with two stars are in the 25 to 50th percentile.

The ratings are based on consumer experience, according to Covered California officials, with a baseline scoring mechanism provided by the Consumer Assessment of Healthcare Providers and Systems.

“After several months of open and constructive debate with consumer advocates, health plans and stakeholders, Covered California is now among the first exchanges in the nation to offer its consumers a quality rating system,” said Peter V. Lee, Covered California's executive director.

Under the Affordable Care Act, state health exchanges are supposed to release health plan ratings by 2016. Lee said the fast start gives consumers “a preliminary look” at the health plans.

Through Dec. 31, 500,108 people purchased insurance via Covered California, officials said. That surpasses the low-end projection of 487,000 enrollments via the exchange before the first open enrollment period ends on March 31. The high-end projection is 696,000. More than 424,000 of those who have enrolled are eligible for income tax credits to subsidize the cost of their premiums.

Rural ACO Formed

An organization based in Nevada City has launched an accountable care organization for rural healthcare providers.

The National Rural ACO includes nine providers in California and Michigan, officials said. The organization decided to band them together in order to overcome federal minimum bars on enrollment for ACO formation.

"Rural health systems provide about 70% of all care to their community. This program will help them coordinate the care provided outside their community and act as advocates for their patients," said NRACO Chairman Timothy Putnam. “Forming the NRACO allowed us to do what is right for our patients and fulfill the mission of serving the health needs of our community, while at the same time blazing a trail for other rural communities to follow."

More details on the NRACO will be published in the next issue of Payers & Providers.

UCSF’s Laret Named Hospital Association’s Chairman

UCSF Medical Center Chief Executive Officer Mark Laret has been named the 2014 chair of the California Hospital Association.

Laret, 60, who has headed UCSF and the UCSF Benioff Children's Hospital since 2000, has previously served as chair of the Association of American Medical Colleges and the National Council of Teaching Hospitals.

“I am honored to lead this distinguished group of more than 400 hospitals and health systems during a challenging period,” Laret said “And, I am optimistic about our abilities, working together, to build an even healthier hospital and health care delivery system in California over the next year.”