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 2018 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 80% 76% 84%
Treating Bronchitis: Getting the Right Care 39% 34% 49%
Asthma Medicine for Adults / Adolescents 79% 79% 85%
Asthma Medicine for Children 87% 88% 94%
Testing Lung Disease 37% 41% 50%
Treating Lung Disease – Bronchodilator Medication 76% 80% 89%
Treating Lung Disease – Corticosteroid Medication 67% 75% 85%
Controlling Blood Pressure for People with Diabetes 66% 59% 77%
Controlling Blood Sugar for People with Diabetes 62% 54% 66%
Eye Exam for People with Diabetes 51% 53% 68%
Prescribing Statins for People with Diabetes 62% 62% 70%
Testing Blood Sugar for People with Diabetes 90% 91% 94%
Testing Kidney Function for People with Diabetes 91% 89% 93%
Controlling High Blood Pressure 60% 55% 74%
Heart Attack Medication 78% 83% 90%
Prescribing Statins to People with Heart Disease 78% 81% 87%
Visits After Giving Birth 72% 73% 88%
Visits During Pregnancy 86% 82% 94%
Alcohol and Drug Dependence Treatment – Ongoing Phase 11% 13% 18%
Alcohol and Drug Dependence Treatment – Initiation Phase 35% 36% 42%
Antidepressant Medication – First three Months of Treatment 68% 69% 77%
Antidepressant Medication – Six Months Continuation of Treatment 52% 53% 62%
Follow-up Visit Within 30 Days After Mental Illness Hospital Stay 65% 66% 78%
Follow-up Visit Within 7 Days After Mental Illness Hospital Stay 44% 44% 59%
Breast Cancer Screening 73% 72% 79%
Cervical Cancer Screening 74% 74% 82%
Chlamydia Screening 54% 49% 65%
Colorectal Cancer Screening 62% 62% 74%
Checking if Weight Could Cause Health Problems 81% 77% 94%
Giving Lab Tests for People Taking Medications for a Long Time 83% 84% 88%
Doctor Advises Patient to Quit Smoking 80% 75% 84%
Flu Shots for Adults 52% 52% 63%
Treating Arthritis With Medications 86% 87% 92%
Immunizations for Early Teens 33% 25% 36%
Ongoing Care for Attention Deficit Disorder 48% 48% 60%
Starting Care for Attention Deficit Hyperactivity Disorder 42% 40% 50%
Checking if Adolescent’s Weight Could Cause Health Problems 69% 65% 88%
Checking If Children's Weight Could Cause Health Problems 71% 67% 89%
Immunizations for Children 53% 52% 68%
Treating Children with Throat Infections 80% 87% 94%
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