For the first time since the state began rating health maintenance organizations in 2000, two Kaiser Permanente plans Thursday earned the highest possible marks – four stars – for meeting national quality care standards.
Three other large HMOs earned lower patient satisfaction ratings than they did a year ago, a disappointment considering the high price of California health care, the state Office of the Patient Advocate said in its annual ratings.
Agency director Sandra Perez acknowledged Kaiser's rating, saying top performers show everybody what is doable. But she said all HMOs still face challenges.
"No California HMO has ever received a four-star satisfaction rating from their patients, and this is concerning," Perez said after releasing the ratings at a news conference in Los Angeles. "California isn't seeing improvement in this area."
The Office of the Patient Advocate informs and educates consumers about their rights as HMO clients. Each year, it rates the nine largest commercial HMOs. Together, they serve 11 million people.
Kaiser Permanente Northern and Southern California region HMOs – rated as separate operations – cheered their four-star ratings in news releases before all the scores were unveiled.
Gregory Adams, president of Kaiser Foundation Health Plan/Hospitals Inc. in Northern California, said the scores were a tribute to Kaiser doctors, nurses and staff for the care they provide to patients.
Western Health Advantage and Blue Shield of California also boosted their scores on meeting national care standards to three stars – "good" – from the two stars – "fair" – they earned in 2007.
Sacramento-based Western Health Advantage, which touts its local roots and patient service, was thrilled with its improved care ratings but was even happier with the top customer satisfaction ratings it earned in nine of 12 subcategories, Chief Executive Garry Maisel said.
The news was not so rosy for some: Blue Shield, along with CIGNA and PacifiCare of California, earned lower patient satisfaction ratings.
CIGNA earned a single star – a "poor" rating – from its patients, the only major HMO to earn a score that low.
CIGNA was disappointed but noted that it improved in some patient care areas.
"We recognize that our customers and individual consumers expect a higher level of service from us, and we are determined to strengthen service delivery and turn around these low scores," CIGNA spokeswoman Gwyn Dilday said.
The patient advocate office said all HMOs are doing a good job helping children, teenagers and adults with asthma avoid attacks.
Yet it said the HMOs are doing poorly helping diabetics control cholesterol and treating adults with bronchitis.
Even the top-rated HMOs gave nearly two-thirds of bronchitis patients an antibiotic when one wasn't needed. At the worst plans, four out of five patients were given such drugs.
"Overuse of antibiotics is not only wasteful and unnecessary, but it can make them less effective in fighting harmful bacteria later," the report said.
Details about the ratings can be found at opa.ca.gov. Or a copy can be requested from the state Department of Managed Health Care at (888) 466-2219.
Call The Bee's Andrew McIntosh, (916) 321-1215.
About Comments
Reader comments on Sacbee.com are the opinions of the writer, not The Sacramento Bee. If you see an objectionable comment, click the "report abuse" button below it. We will delete comments containing inappropriate links, obscenities, hate speech, and personal attacks. Flagrant or repeat violators will be banned. See more about comments here.