The State of California Office of the Patient Advocate released the 2021-2022 Edition of Health Care Quality Report Cards for Medical Group Commercial and Medical Group – Medicare. These include:
Cost Ratings for Medical Groups
The latest Total Cost of Care ratings were developed by comparing medical groups’ costs during 2020. Each medical group’s average monthly costs were calculated by assessing the total actual payments made by both health plans and patients for the care provided to patients.
2021-22 Edition of the Medical Group – Medicare Advantage Report Card
The latest Report Card has Quality of Medical Care ratings for 169 medical groups that serve Medicare Advantage members. Each year, patient records are reviewed to determine if the medical care provided meets national standards for using treatments proven to be effective. The Report Card provides star ratings on overall quality of medical care and ratings on 12 specific clinical measures, including those related to diabetes care, cancer screenings, and arthritis treatment.
Also available from CA OPA:
HMO and PPO Quality Ratings
The 2021-22 Edition of the Health Plan Report Card offers quality ratings for the 10 largest HMO plans and 6 largest PPO plans in California. The Report Card provides overall star ratings based on evaluations of medical records and patient surveys. Also allows for the comparison of health plan scores on more than 50 specific health care topics and quality measures, such as for behavioral health, immunizations for children, heart care, preventing hospital readmissions, patient satisfaction with plan doctors, and more.
Note: The Office of the Patient Advocate (OPA) is now a part of the new Center for Data Insights and Innovation (CDII). OPA’s duties were transferred to CDII after Governor Gavin Newsom signed AB 172 into law on October 8, 2021. CDII is a newly-created state office within the California Health & Human Services Agency (CalHHS) with a mandate to advance CalHHS data initiatives and a mission to turn data into insights, knowledge, and action. More information available at https://www.chhs.ca.gov/home/data/
- Health Care Quality Report Cards 2021-22 Edition. State of California Office of Patient Advocate