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%