What Was Measured?

This page contains the average of the scores of California’s largest HMO and point of service (POS) health plans on 32 National Committee for Quality Assurance (NCQA) HEDIS clinical quality measures collected in 2007 and reported in 2008, compared to the average for HMO and POS plans across the nation. The California plans used for this analysis were Aetna Health of California, Anthem Blue Cross HMO - California Care, Blue Shield of California HMO, CIGNA HMO, HealthNet of California, Kaiser Permanente, PacifiCare of California, and Western Health Advantage. The national average includes all of the health plans from California. The averages were calculated giving equal weight to each HMO/POS score. Weighting the California and national HMO/POS scores by the number of enrollees per health plan would result in different scores.

Why Is It Important?

Everyone would like to think that the quality of care they receive is the best in the country. Comparing California HMO/POS scores to national averages shows us where we are doing well, and where there are opportunities to improve. The averages also indicate what health care services representing high quality care you are most likely to receive, and what services are performed less frequently.

What Was the Source?

NCQA collects and reports on HEDIS quality of care measures as part of the voluntary accreditation process for HMOs. Data on HMO and POS enrollees voluntarily reported by California health plans to the National Committee for Quality Assurance (NCQA) is made available through NCQA’s Quality Compass®. This comparison of California HMO/POS healthplans to national averages was compiled from data publicly reported in the NCQA 2008 Quality Compass®. HMO and POS data are reported together here because Quality Compass® does not separate HMO and POS membership in its report.

California HMO/POS Plans vs. the National Average

 

California Average:

California HMO/POS plans scored on meeting national standards of care

National Average:

National HMO/POS plans scored on meeting national standards of care
Asthma Medicine for Adults 91% 91%
Asthma Medicine for Teenagers 92% 94%
Asthma Medicine for Children 96% 97%
Breast Cancer Screening 70% 69%
Cervical Cancer Screening 84% 82%
Colorectal Cancer Screening 57% 57%
Chlamydia Screening Age 16-20 43% 36%
Chlamydia Screening Age 21-25 50% 39%
Eye Exam for Diabetes Patients 59% 55%
Testing Blood Sugar for Diabetes Patients 88% 88%
Controlling Blood Sugar for Diabetes Patients 73% 71%
Testing Cholesterol for Diabetes Patients 85% 84%
Controlling Cholesterol for Diabetes Patients 46% 44%
Testing Kidney Function for Diabetes Patients 84% 80%
Controlling Blood Pressure For Diabetes Patients 68% 64%
Controlling High Blood Pressure 65% 62%
Testing Cholesterol 90% 88%
Controlling Cholesterol 65% 60%
Heart Attack Medication 74% 73%
Visits During Pregnancy 94% 93%
Visits After Giving Birth 84% 83%
Alcohol & Drug Dependence Treatment 12% 16%
Anti-depressant Medication —
Initial Treatment
63% 62%
Anti-depressant Medication —
Ongoing Treatment
47% 45%
Follow-up Visit After Mental Illness Hospital Stay 74% 74%
Checking Patients on Long-Term Medications 70% 77%
Treating Arthritis With Medications 84% 85%
Treating Bronchitis With Antibiotics 23% 24%
Child Immunizations 78% 77%
Treating Children with Throat Infections 53% 75%
Treating Children with Upper Respiratory Infections 88% 83%
Care for Attention Deficit Disorder 29% 34%
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