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
Testing for Cause of Back Pain	81%	77%	85%
Treating Bronchitis: Getting the Right Care	42%	37%	50%
Asthma Medicine for Adults / Teens	75%	78%	84%
Asthma Medicine for Children	85%	88%	95%
Testing Lung Disease	37%	40%	50%
Treating Lung Disease: Bronchodilator Medicine	80%	79%	89%
Treating Lung Disease – Corticosteroid Medicine	71%	76%	87%
Controlling Blood Pressure for People with Diabetes	65%	59%	77%
Controlling Blood Sugar for People with Diabetes	61%	55%	66%
Eye Exam for People with Diabetes	51%	53%	68%
Prescribing Statins for People with Diabetes	65%	63%	70%
	90%	91%	94%
	91%	90%	93%
Controlling High Blood Pressure	62%	56%	74%
Heart Attack Medicine	81%	85%	93%
Prescribing Statins to People with Heart Disease	81%	81%	88%
Visits After Giving Birth	79%	77%	92%
Visits During Pregnancy	86%	81%	95%
Alcohol and Drug Dependence Treatment – Ongoing Phase	13%	13%	18%
Alcohol and Drug Dependence Treatment: Beginning Phase	38%	36%	42%
Antidepressant Medicine – First three Months of Treatment	69%	71%	78%
Antidepressant Medicine – Six Months Continuation of Treatment	53%	55%	63%
Follow-up Visit Within 30 Days After Mental Illness Hospital Stay	67%	67%	80%
Follow-up Visit Within 7 Days After Mental Illness Hospital Stay	47%	45%	59%
Breast Cancer Screening	75%	73%	79%
Cervical Cancer Screening	77%	75%	82%
Chlamydia Screening	57%	50%	66%
Colorectal Cancer Screening	65%	64%	75%
Checking if Weight Could Cause Health Problems	82%	79%	95%
Doctor Advises Patient to Quit Smoking	78%	73%	85%
Flu Shots for Adults	56%	55%	66%
Immunizations for Early Teens	34%	28%	40%
Ongoing Care for Attention Deficit Disorder	46%	47%	59%
Starting Care for Attention Deficit Hyperactivity Disorder	40%	40%	49%
Checking if Teen’s Weight Could Cause Health Problems	68%	66%	88%
Checking if Children’s Weight Could Cause Health Problems	70%	69%	90%
Immunizations for Children	50%	54%	71%
Treating Children with Throat Infections	78%	85%	93%

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