News: 2009 Press Release
For Release: November 17, 2009
Media Calls Only: 916-492-3566
Insurance Commissioner Poizner Launches Nation's First Online PPO Rating Report Card
California Insurance Commissioner Steve Poizner today announced the launch of a new report card on the Department of Insurance's Web site (www.insurance.ca.gov) that will allow consumers to make more informed choices about which Preferred Provider Organization (PPO) is best for them, and will allow everyone to monitor how well our health care system is doing in assuring the right care is given to the right patients.
"Consumers need the best possible information and transparency when choosing their health insurance provider," said Commissioner Poizner. "This report card will provide information that has been lacking for too many years. It is based on a four-star rating system that is easy to understand, yet gives consumers the ability to dig deeper and find how well each insurer does on dozens of specific best practices. The report card provides a one-stop shopping experience for California's major PPO providers."
Commissioner Poizner pledged in August 2007 to make sure PPO patients had the same information HMO patients currently have. California's Department of Managed Health Care (DMHC) has provided a report card on Health Maintenance Organizations (HMO) since 2002, but until today, PPOs lacked a similar objective comparison. While other states collect similar data, California is the only state to analyze it, and offer it in a consumer-friendly, interactive format that includes summary ratings as well as the more detailed underlying measurements.
None of the five PPOs on the report card received the highest four-star rating, but Aetna, CIGNA HealthCare of California and Health Net of California each received three stars overall. United Healthcare and Anthem Blue Cross each received two stars overall. Blue Shield of California did not report findings due to technical issues, but expects to report data next year.
Rating criteria included asthma care, checking for cancer, diabetes care and treatment of children. The ratings are based on a set of standard measures developed by the National Committee on Quality Assurance. In addition to grades based on the clinical best practices, the report also includes results of a voluntary survey completed by plan members related to consumer satisfaction. (See fact sheet for a more thorough explanation of the methodology.)
"This type of report on PPOs has never been done before," Commissioner Poizner said, "but California is setting the bar higher for everyone. The value to consumers is huge, but the benefits to the entire health care system are even greater. We now have a baseline, and every insurer knows their performance needs to get better every year. Consumers are watching."
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