No other state has such a report card for PPOs. "The quality of health care should not be a mystery to consumers," said Commissioner Poizner. "I want to raise the bar of health quality in California. Consumers should know what they're getting when they pay their health care premiums." Poizner announced that California's largest PPO health plans - Aetna, Blue Shield, Cigna, HealthNet, WellPoint and United - have agreed to collect data on quality of care and patient satisfaction and make this information public. The plans will be rated on measures now used for HMOs: Healthcare Effectiveness Data and Information Set (HEDIS®), which focuses on clinical factors, and the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data, for consumer satisfaction with their health insurer.
The National Committee on Quality Assurance
(NCQA) has used these measures to compare HMOs for years, and announced this
month that, for the first time, they would extend this program to PPOs as well.
Making this information public provides a strong incentive for insurers to focus on quality and
delivery of health care. NCQA has
shown that such reporting has significant healthcare improvements in areas such
as diabetes, cardiovascular disease, immunizations and mammograms. Commissioner
Poizner was joined by Sandra Perez, Director of the Office of Patient Advocate,
whose office has produced an HMO Quality of Care Report Card for the last seven
years. Poizner also welcomed high-level representatives from the PPO plans that
will participate in the program. "Giving consumers more information about their choices in quality
health care is a top priority. Commissioner Poizner is rising to the challenge
of an aggressive healthcare reform agenda which Governor Schwarzenegger has
brought to center stage this year," said Sandra Perez, Director of
California's Office of the Patient Advocate in the Department of Managed Health
Care. "Through the Office of the Patient Advocate, HMO patients already
have easily accessible information about their rights and responsibilities and
it only makes sense that PPO consumers have the same information at their
fingertips." The Department of Insurance
will deliver the first Health Insurance Report Card by 2009.