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Monday, 06 August 2007 23:55

Insurance Commissioner Creates New Report Card For Health Insurers

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slide31California Insurance Commissioner Steve Poizner announced a new program yesterday that will provide consumers with a “report card” for Preferred Provider Health care plans. Poisner announced that California's six largest Preferred Provider Organizations (PPOs) have agreed to initiate quality of care measures, including accreditation by nationally recognized institutions. They have also agreed to provide information for the Commissioner's effort to create a Health Insurance Report Card for California consumers.

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.

slide37 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.

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