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Home / News & IndustryManaged Care Insight and Analysis
Updated: November 30, 2010
School Days: Kaiser Permanente Aces OPA Test

Kaiser Permanente received the highest grades on a report card released by the California Office of the Patient Advocate (OPA).

The OPA’s HMO Ratings At-a-Glance, 2010 Edition, provided a look at health plan performance in two categories: Meeting National Standards of Care and Members Rate their HMO.

The health plans assessed were: Aetna Health of California Inc.; Anthem Blue Cross – HMO; Blue Shield of California HMO; CIGNA HMO; Health Net of California Inc.; Kaiser Permanent, Northern California and Southern California; PacifiCare of California and Western Health Advantage.

Kaiser Permanent in Southern California was the only plan to get four-star ratings in both categories while its northern California plan got four stars for meeting national standards and three stars from its members. The other plans received three stars in both categories, except for California Blue Shield and CIGNA HMO which received two stars from their members.

To determine the ratings in the two categories quality scores were constructed using the HEDIS and CAHPS quality performance systems. The quality measures are based on the services, care, and experiences of samples of commercial HMO members who were enrolled in the HMO throughout 2008. Medical chart and service records were collected and HMO members were surveyed in a standardized way through the coordination of the California Cooperative Healthcare Reporting Initiative.

To determine member ratings each year, OPA contacts a sample of HMO members by mail or phone to complete a CAHPS survey. Typically, about one-third of the members contacted answer the survey. The survey asks members to rate all of their experience with the health plan and is a good summary of members’ reported experiences across areas ranging from customer service to finding a doctor.

Address: Kaiser Permanente, One Kaiser Plaza, Oakland, CA 94612; (510) 271-5910, www.kp.org.


  This article was taken from:
The Executive Report on Managed Care

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