California Health Plans Compared to Health Plans Nationwide

What do the stars mean?

California’s health plans’ quality scores are compared to results of health plans throughout the United States. A set of standard patient experience 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 2022. The California plans’ scores are the average across all 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 CAHPS 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 2023 Quality Compass®.
Scores for the CAHPS® topics are based on the percentage of members who gave high scores or the most positive answers ("always" or "usually" for most questions) to the survey question. For most questions, answers are scored using one of four possible choices ranging from the member “always” had a positive experience to the member “never” had a positive experience.


California Average:

California Health Plans

National Average:

Health Plans Nationwide

National 90th Percentile:

Top Health Plans Nationwide
Preventing Hospital Readmission After Discharge NA NA NA
Testing for Cause of Back Pain 79% 76% 83%
Treating Bronchitis: Getting the Right Care 44% 42% 55%
Asthma Medicine for Adults / Teens 81% 84% 91%
Asthma Medicine for Children 89% 90% 96%
Testing Lung Disease 30% 34% 43%
Treating Lung Disease: Bronchodilator Medicine 84% 82% 90%
Treating Lung Disease – Corticosteroid Medicine 71% 76% 85%
Controlling Blood Pressure for People with Diabetes 63% 61% 76%
Controlling Blood Sugar for People with Diabetes 60% 58% 69%
Eye Exam for People with Diabetes 53% 51% 64%
Prescribing Statins for People with Diabetes 68% 64% 70%
Controlling High Blood Pressure 61% 60% 74%
Heart Attack Medicine 83% 85% 92%
Prescribing Statins to People with Heart Disease 82% 82% 88%
Visits After Giving Birth 80% 81% 93%
Visits During Pregnancy 84% 81% 94%
Alcohol and Drug Dependence Treatment – Ongoing Phase 13% 14% 19%
Alcohol and Drug Dependence Treatment: Beginning Phase 37% 37% 45%
Antidepressant Medicine – First three Months of Treatment 75% 77% 83%
Antidepressant Medicine – Six Months Continuation of Treatment 59% 61% 69%
Follow-up Visit Within 30 Days After Mental Illness Hospital Stay 70% 70% 80%
Follow-up Visit Within 7 Days After Mental Illness Hospital Stay 48% 48% 62%
Breast Cancer Screening 74% 73% 80%
Cervical Cancer Screening 75% 74% 81%
Chlamydia Screening 51% 47% 62%
Colorectal Cancer Screening 57% 57% 67%
Doctor Advises Patient to Quit Smoking 72% 75% 78%
Flu Shots for Adults 56% 54% 66%
Immunizations for Early Teens 37% 33% 46%
Ongoing Care for Attention Deficit Disorder 49% 48% 59%
Starting Care for Attention Deficit Hyperactivity Disorder 44% 42% 51%
Checking if Teen’s Weight Could Cause Health Problems 68% 68% 87%
Checking if Children’s Weight Could Cause Health Problems 72% 70% 88%
Immunizations for Children 52% 54% 71%
Treating Children with Throat Infections 71% 81% 89%