The Office of the Patient Advocate's mission is to improve California health care quality and advocate for consumer interests by publicly reporting data for informed decision making.
OPA's statutory charge is to better enable health care consumers to access the health care services for which they are eligible. OPA fulfills that mandate by publishing report cards on health care quality and by analyzing data from state agency consumer assistance centers.
OPA's two main programs are:
OPA displays clinical performance and patient experience data for the state's largest HMO and PPO health plans on the Health Plan Report Card. These plans are responsible for providing health care services to more than 15 million commercially insured Californians.
OPA has also introduced cost of care ratings for more than 200 of the state’s commercial medical groups, in addition to clinical performance and patient experience data on the Commercial Medical Group Report Card.
Clinical performance scores for more than 180 Medicare Advantage Medical Groups are also displayed on the Medicare Medical Group Report Card.
OPA’s annual Complaint Data Report provides a meaningful analysis of consumer health care complaints, enabling the identification of systemic problems or disparities and the promotion of effective complaint resolution efforts. The report provides the legislature and other stakeholders with information about the state’s health care consumer assistance centers and consumer complaints reported to the Department of Managed Health Care, Department of Health Care Services, Department of Insurance, and Covered California. In alignment with our efforts to publicly report accessible data on the quality of California’s health plans, OPA also reports a complaint performance metric that allows consumers to compare health plans’ complaint rates (annual complaints against each health plan per plan member).