What do the scores mean?
California’s largest HMO health plans’ quality scores are compared to results of HMO plans throughout the U.S. A set of standard quality measures are used to compare the average performance among HMOs in California to the HMO 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 HMO results nationwide. These scores largely are based on patient care provided in 2010.
The California plans’ scores are the average across the State’s eight (8) largest HMOs: Aetna Health of California, Anthem Blue Cross HMO, Blue Shield of California HMO, CIGNA HMO, Health Net of California, Kaiser Permanente, PacifiCare of California, Sharp Health Plan, and Western Health Advantage. The nationwide results are from HMO health plans located throughout the U.S. and were calculated giving equal weight to each plan’s score regardless of its number of enrollees.
Why Is It Important?
Comparing California HMO scores to national performance shows the strengths of the HMOs in the State and those areas in which there are opportunities to improve. The 90th percentile results show the performance of the best HMO health plans nationwide.
What Was the Source?
The National Committee on Quality Assurance (NCQA) collects and reports on HEDIS quality of care measures as part of its nationwide health plan accreditation program. These HMO scores include 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 2011 Quality Compass®.