HMO and PPO Quality Ratings Summary 2020-21 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 Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs). The 10 largest HMOs and 6 largest PPOs in the state are included in this Report Card.
- In this Report Card, the star ratings for "Patients Rate Overall Experience" are one year older (2018) than the star ratings for "Quality of Medical Care"(2019). This is because of concerns about reporting bias when asking patients to report their experience from the previous year, during the COVID-19 pandemic.
Click
here to see how the COVID-19 pandemic has affected the collection and reporting of patient experience data in California and throughout the country.
What’s the difference between HMOs and PPOs?
With an HMO you can only see doctors in your HMO’s network. You will have a
primary care doctor and a medical group who refers and coordinates your care to specialists when needed. With a PPO you can choose to see out-of-network doctors. You are responsible to manage and pay the cost for out-of-network visits.
Click on each health plan name to find its consumer assistance number, service area, website and more.