California Health Plans Compared to Health Plans Nationwide

What do the scores mean?

California’s largest health plans’ quality scores are compared to results of health plans throughout the United States. A set of standard quality measures are used to compare the average performance among health plans in California to the health plan national average and to the best performing plans in the country — the 90th percentile results are scores that are better than 90 percent of the plan results nationwide. These scores largely are based on patient care provided in 2016.

The California plans’ scores are the average across California health plans. The nationwide results are from health plans located throughout the United States and were calculated giving equal weight to each plan’s score regardless of its number of enrollees.

What Is the Source?

The National Committee for Quality Assurance (NCQA) collects and reports on HEDIS quality of care measures as part of its nationwide health plan accreditation program. These health plan scores include PPO plans as well as several managed healthcare insurance products which are commonly called HMO and POS (Point of Service) health plans. This comparison of California health plans to national scores uses data that was reported in the NCQA 2017 Quality Compass®.

 

California Average:

California Health Plans

National Average:

Health Plans Nationwide

National 90th Percentile:

Top Health Plans Nationwide
Testing for Cause of Back Pain 79% 76% 84%
Treating Bronchitis: Getting the Right Care 35% 31% 44%
Asthma Medicine for Adults / Adolescents 79% 78% 85%
Asthma Medicine for Children 86% 87% 94%
Testing Lung Disease 35% 40% 49%
Treating Lung Disease – Bronchodilator Medication 82% 80% 88%
Treating Lung Disease – Corticosteroid Medication 71% 75% 84%
Controlling Blood Pressure for People with Diabetes 65% 56% 76%
Controlling Blood Sugar for People with Diabetes 61% 53% 66%
Eye Exam for People with Diabetes 52% 52% 69%
Prescribing Statins for People with Diabetes 62% 61% 68%
Testing Blood Sugar for People with Diabetes 90% 90% 94%
Testing Kidney Function for People with Diabetes 90% 89% 93%
Controlling High Blood Pressure 59% 58% 75%
Heart Attack Medication 81% 85% 92%
Prescribing Statins to People with Heart Disease 78% 81% 87%
Visits During Pregnancy 85% 81% 94%
Visits After Giving Birth 76% 71% 87%
Alcohol and Drug Dependence Treatment – Initiation Phase 35% 37% 42%
Alcohol and Drug Dependence Treatment – Ongoing Phase 12% 13% 18%
Antidepressant Medication – First three Months of Treatment 65% 68% 75%
Antidepressant Medication – Six Months Continuation of Treatment 50% 52% 61%
Follow-up Visit Within 7 Days After Mental Illness Hospital Stay 47% 46% 62%
Follow-up Visit Within 30 Days After Mental Illness Hospital Stay 68% 68% 80%
Breast Cancer Screening 73% 71% 79%
Cervical Cancer Screening 74% 74% 82%
Chlamydia Screening 55% 48% 64%
Colorectal Cancer Screening 62% 61% 73%
Checking if Weight Could Cause Health Problems 83% 73% 93%
Giving Lab Tests for People Taking Medications for a Long Time 83% 83% 87%
Doctor Advises Patient to Quit Smoking 77% 75% 84%
Flu Shots for Adults 52% 50% 60%
Treating Arthritis With Medications 88% 88% 93%
Immunizations for Children 53% 51% 66%
Immunizations for Early Teens 32% 22% 31%
Checking If Children's Weight Could Cause Health Problems 70% 64% 88%
Checking if Adolescent’s Weight Could Cause Health Problems 70% 62% 86%
Starting Care for Attention Deficit Hyperactivity Disorder 40% 41% 52%
Ongoing Care for Attention Deficit Disorder 47% 47% 59%
Treating Children with Throat Infections 79% 86% 94%
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