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Medical Group Report Card ratings for Commercial HMO Plan Members 2021-22 Edition

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Quality health care is getting the right care at the right time.


Review the star ratings in the columns below. More stars are better. Both quality and cost of care are important to consider when choosing a medical group. Cost information will be available with the Spring release of the report card.


The Report Card also provides other helpful information on each medical group. Click on each medical group name to find all of its star ratings, consumer assistance number, service area, website and more.


“Due to the COVID-19 pandemic, healthcare providers had to rethink the ways they provide necessary care. The Integrated Healthcare Association (IHA), who provides the data on this page about medical groups, worked with its oversight committees to select a smaller set of measures for the 2021-2022 Edition Medical Group Report Card, focusing on high-priority services during the pandemic.

2021-2022 Edition Medical Group Report Card star ratings may not fully capture how COVID-19 impacted different areas of California in different ways. To see the 2020-2021 Edition of the Medical Group Report Card, based on data collected before the pandemic, Click here

For more detail on how the list of measures approved for public reporting has changed for 2020, please refer to the Medical Group Methodology Document. For any questions, please contact amp@iha.org.”






QUALITY OF MEDICAL CARE




The California Office of the Patient Advocate compared medical group performance results in 2020 to a set of national standards for quality of care to make sure that medical groups offer quality preventive care and treatment services to members. More stars are better.


Patient Experience is a separate rating. Ratings for Patient Experience are in the column to the right, Patients Rate Overall Experience

PATIENTS RATE OVERALL EXPERIENCE



The California Office of the Patient Advocate compared how medical group patients rated their experience with their medical group during 2020. More stars are better.

TOTAL COST OF CARE




The California Office of the Patient Advocate compared the average amount of money that health plans and patients pay for all of the care a patient receives each month during 2019. Groups with lower costs receive a higher star rating. More stars are better.

The dollar ranges below include the average amount paid by health plans for things like check-ups and tests, plus the average amount paid by patients for things like co-pays and monthly insurance premiums.
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Humboldt IPA
Fair
Good

TOTAL COST OF CARE

Higher cost care does not necessarily mean higher quality care

Medical groups may actually help to keep costs lower by providing better care.

A medical group may have lower costs because it:

  • Control costs associated with rent, staff salaries, equipment or the cost of other providers outside of the medical group.
  • Provides only tests or treatments that patients need.
  • Prevents medical errors-such as giving the wrong diagnosis or the wrong medicine-when providing care to patients, which have to be corrected with additional resources.
  • Follows up with patients and/or their caregivers after a hospital stay, helping to prevent unwanted return visits to the hospital.

Factors like higher rent and staff salaries, serving higher risk or sicker patients, serving more people without insurance, providing medical education, or providing other services that help the community may drive up costs.

321.000
 

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