PPO Quality Ratings Summary 2015-16 Edition

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

This Report Card shows the quality of health care for millions of Californians who get their care through commercial insurance provided by Preferred Provider Organizations (PPOs). The 6 largest PPOs in the state are included in this Report Card.

The PPO Report Card includes health care quality scores for two major areas:

  • Clinical Performance Scores – See the “PPO Provides Recommended Care” column below. To find more information on 11 health conditions/topics go to the dark blue box in the right column.
  • Patient Experience Scores – See the 3 columns below under “Patients Rate their Experience.” Additional information is found in the light blue box in the right column.

The Report Card also provides other helpful information on each PPO. Click on each health plan name to find its consumer assistance number, service area, website and more.
Learn more about these ratings.

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PPO Provides Recommended Care

The California Office of the Patient Advocate compared PPO members’ records in 2014 to a set of national standards for quality of care to make sure that health plans are offering quality preventive care and service to members.

Patients Rate Their Experience

Click on plan name for plan’s star ratings and information:

Rate Their PPO
We compared how PPO members rated their care and services with a 9 or 10 on a 0 to 10 scale during 2014.
Getting Care
Members rated ease of getting doctor appointments, tests and treatments during 2014.
PPO Helps Members Get Answers
Members who contacted their plan rated the customer service provided and whether they got accurate information on plan costs and claims payment during 2013 and 2014.
Aetna PPO FairTwo stars FairTwo stars GoodThree stars PoorOne star
Anthem Blue Cross PPO GoodThree stars PoorOne star GoodThree stars FairTwo stars
Blue Shield of California/Blue Shield Life PPO FairTwo stars PoorOne star PoorOne star PoorOne star
Cigna PPO GoodThree stars FairTwo stars PoorOne star PoorOne star
Health Net PPO FairTwo stars PoorOne star FairTwo stars PoorOne star
UnitedHealthcare Insurance Co., Inc. FairTwo stars GoodThree stars FairTwo stars PoorOne star

Data Disclaimer  
The source for data contained in this publication is Quality Compass® 2015 and is used with the permission of the National Committee for Quality Assurance (NCQA). Quality Compass 2015 includes certain CAHPS data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors, and NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass is a registered trademark of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

Users of the data shall not have the right to alter, enhance, or otherwise modify the data. Anyone desiring to use or reproduce the data without modification for a noncommercial purpose may do so without obtaining any approval from NCQA. All commercial uses must be approved by NCQA and are subject to a license at the discretion of NCQA. Use by health care providers in connection with their own practices is not commercial use. A "commercial use" refers to any sale, license, or distribution of the data for commercial gain, or incorporation of the data into any product or service that is sold, licensed, or distributed for commercial gain, even if there is no actual charge for inclusion of the data. ©2004-2016 National Committee for Quality Assurance, all rights reserved.

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