California Health Plans Compared to Health Plans Nationwide

What do the scores 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 2021. 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 2022 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
Testing for Cause of Back Pain	81%	78%	85%
Treating Bronchitis: Getting the Right Care	47%	44%	58%
Preventing Hospital Readmission After Discharge	NA	NA	NA
Asthma Medicine for Adults / Adolescents	81%	81%	88%
Asthma Medicine for Children	89%	90%	96%
Testing Lung Disease	32%	36%	45%
Treating Lung Disease – Bronchodilator Medication	82%	81%	91%
Treating Lung Disease – Corticosteroid Medication	67%	75%	86%
Controlling Blood Pressure for People with Diabetes	59%	58%	74%
Controlling Blood Sugar for People with Diabetes	59%	55%	67%
Eye Exam for People with Diabetes	50%	50%	64%
Prescribing Statins for People with Diabetes	69%	65%	71%
Testing Blood Sugar for People with Diabetes	89%	90%	94%
Controlling High Blood Pressure	59%	56%	73%
Heart Attack Medication	81%	85%	92%
Prescribing Statins to People with Heart Disease	NA	NA	NA
Visits After Giving Birth	82%	79%	93%
Visits During Pregnancy	83%	79%	94%
Alcohol and Drug Dependence Treatment – Ongoing Phase	13%	12%	17%
Alcohol and Drug Dependence Treatment – Initiation Phase	34%	35%	41%
Antidepressant Medication – First three Months of Treatment	74%	76%	82%
Antidepressant Medication – Six Months Continuation of Treatment	58%	60%	67%
Follow-up Visit Within 30 Days After Mental Illness Hospital Stay	71%	70%	81%
Follow-up Visit Within 7 Days After Mental Illness Hospital Stay	48%	48%	61%
Breast Cancer Screening	71%	71%	78%
Cervical Cancer Screening	75%	74%	80%
Chlamydia Screening	52%	46%	62%
Colorectal Cancer Screening	63%	63%	72%
Doctor Advises Patient to Quit Smoking	78%	80%	93%
Flu Shots for Adults	57%	55%	66%
Immunizations for Early Teens	36%	32%	44%
Ongoing Care for Attention Deficit Disorder	49%	45%	59%
Starting Care for Attention Deficit Hyperactivity Disorder	41%	37%	48%
Checking if Adolescent’s Weight Could Cause Health Problems	66%	66%	85%
Checking If Children's Weight Could Cause Health Problems	69%	69%	88%
Immunizations for Children	56%	57%	73%
Treating Children with Throat Infections	65%	80%	89%

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