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 2006 and reported in 2007, compared to the average for HMO and POS plans across the nation. The California plans used for this analysis were Aetna Health of California, 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 2007 Quality Compass®. HMO and POS data are reported together here because Quality Compass® does not separate HMO and POS membership in it’s 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%	90%
Asthma Medicine for Teenagers	92%	93%
Asthma Medicine for Children	96%	96%
Breast Cancer Screening	69%	69%
Cervical Cancer Screening	83%	82%
Colorectal Cancer Screening	51%	56%
Eye Exam for Diabetes Patients	60%	54%
Testing Blood Sugar for Diabetes Patients	87%	87%
Controlling Blood Sugar for Diabetes Patients	72%	70%
Testing Cholesterol for Diabetes Patients	85%	83%
Controlling Cholesterol for Diabetes Patients	45%	43%
Testing Kidney Function for Diabetes Patients	83%	79%
Controlling High Blood Pressure	63%	59%
Testing Cholesterol	91%	88%
Controlling Cholesterol	62%	57%
Heart Attack Medication	72%	72%
Visits During Pregnancy	93%	92%
Visits After Giving Birth	84%	81%
Treatment Visits for Depression	22%	21%
Anti-depressant Medication — Initial Treatment	64%	61%
Anti-depressant Medication — Ongoing Treatment	47%	45%
Follow-up Visit After Mental Illness Hospital Stay	78%	76%
Chlamydia Screening Age 16-20	42%	35%
Chlamydia Screening Age 21-25	48%	37%
Checking Patients on Long-Term Medications	68%	74%
Treating Arthritis With Medications	82%	85%
Treating Bronchitis With Antibiotics	68%	73%
Care for Attention Deficit Disorder	27%	34%
Child Immunizations	66%	66%
Adolescent Immunizations	59%	59%
Treating Children with Throat Infections	50%	73%
Treating Children with Upper Respiratory Infections	84%	82%