California ranks Kaiser best-rated HMO

| February 13, 2015 | 0 Comments

careIt’s that time of year again. Holiday decor is being put up in stores, turkeys are being purchased for Thanksgiving and Californians are preparing for fall open enrollment. Beginning in November and running through February, California’s insurance exchange period is a time in which millions of Californians will research the best plans and providers available.

Officials from the Office of the Patient Advocate have announced that Kaiser is the top-rated HMO provider in the state. With a four-star rating, Kaiser is ranking as high in its category as several other well-known providers such as Anthem Blue Cross and Cigna Corp.

Known nationwide and standing as the state’s biggest for-profit insurer, Anthem Blue Cross is hard to compare with. Yet Kaiser’s ranking as an HMO is four stars; Anthem Blue Cross and Cigna Corp, which are the leading PPO plans in the state, have three-star ratings.

According to the report card issued by the Office of the Patient Advocate, which can be found on their website, http://www.opa.ca.gov, there are several reasons why Kaiser is in the lead. First and foremost, Kaiser’s high rating results from feedback from HMO members. People who are members of the Kaiser HMO give the provider five stars out of five. Members report general satisfaction with their experiences.

One of the ways in which members of Kaiser reportedly gained such satisfaction was through the HMO’s easy provision of answers. It is common for people who change, use or join an HMO to have questions about payment plans, policies and more. It is no surprise then that Kaiser’s consistent and helpful answers impressed many. The HMO earned two stars in this specific arena.

Californians often report frustration with their access to care. Yet, easily getting care is one of the most important things that providers can offer to members. Kaiser takes the lead in this category. Members report three star satisfaction with northern California’s Kaiser Permanente HMO. The southern part of the state gives the HMO two stars in this category.

Meanwhile, other providers largely received one out of five stars for the ease of care they offer. That both the northern and southern branches of the Kaiser organization did better in this category is outstanding; Kaiser ranked four stars out of five. This is especially the case, considering the terms of the data collected to create this report card.

The competitive ranking is for the six largest preferred providers in the region. These organization plans are huge, reaching and providing care for 16 million consumers in the state. The plans cover more than 200 physician groups as well.

The data collected to create these rankings was based on surveys taken by patients across the state. Additional information was gathered and factored in from claims that have been filed in 2013. This data thus relied both on patient and member feedback directly, and on evidence based on how patient and member claims were processed.

Overall, Kaiser ranks best on this report card as an HMO by a significant margin, as it is the only one to receive a four star rating. Such favorable feedback from members and from research is echoed by Kaiser’s affiliation with UCLA, Cedars-Sinai Medical Center and HealthCare Partners. These groups received three out of four stars according to national guidelines.

For consumers considering their options as fall open enrollment begins, this report card was released early for a reason. Providers like Kaiser are plentiful, and each organization has its strengths and weaknesses.

Start considering your options by finding out your employer health plan options. You might also research individual policies. Then, check out the specific information provided by the Office of the Patient Advocate report card. Also consider the statement made by the executive director of Health Access, Anthony Wright, “We advise consumers to use the online tools to go beyond the headline ratings and click through to the details that might be most important to them.”

Designed to be useful for Californians during the enrollment period, the report card has features that allow consumers such as you to find out what matters most. For instance, you can search for information about your specific medical concerns. If you have asthma, you can use the report card search tool to find out about similar patient complaints or claims against each health insurer you are considering.

Diana Dooley, who is the secretary of California’s Health and Human Services Agency hopes that in the coming weeks, Californians who are facing so many choices of health care plans will find a useful resource from the report cards. She speaks from experience, being an insurance-covered California board member herself.

Category: Health Tips

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