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.

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The California Office of the Patient Advocate compared health plan members' records in 2019 to a set of national standards for quality of care to make sure that health plans offer quality preventive care and treatment services to members. More stars are better.

The star ratings below are based on quality of medical care data collected in 2019 and reported in 2020.

Patient Experience is a separate rating. Ratings for Patient Experience are in the column to the right, Patients Rate Overall Experience.


The California Office of the Patient Advocate compared how people with health insurance rated their experience with the care and services offered by their health plan during 2018. More stars are better.

The star ratings below are based on patient experience data collected in 2018 and reported in 2019. This is because the patient experience data collected in 2019 and reported in 2020 might be biased due to the COVID-19 pandemic.

Data Disclaimer  
The source for data contained in this publication is Quality Compass®2017 and is used with the permission of the National Committee for Quality Assurance (NCQA). Quality Compass® 2017 includes certain Consumer Assessment of Healthcare Providers and Systems (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. ©2004-2017 National Committee for Quality Assurance, all rights reserved.