About the Quality of Care Report Card: Quality Matters
When it comes to health care, it is important to have information to assist you in making the choices that are right for you and your family. There are many factors that go into deciding who you will trust with your health care, including cost, convenience, and quality. The purpose of this Quality of Care Report Card is to provide health care users like yourself with information on how the medical care and service provided by your health plan (also known as HMO) stacks up against other HMOs.
These ratings concern aspects of medical care and service that affect most people. Although you might not have conditions such as diabetes that are included in the report card, how HMOs care for patients with diabetes tells a lot about how the HMO helps members with any condition. Similarly, an HMO that makes sure women are screened for breast cancer after age 40 may be working to see that every member who is at risk for a disease gets proper testing.
This report card was created by The Office of the Patient Advocate (OPA). OPA was created by legislation that was signed by the governor in 1999. One of OPA's most important responsibilities is to create the Quality of Care Report Card and report results yearly. OPA has contracted with a company called Pacific Business Group on Health (PBGH) to help analyze publicly reported quality information and to compile it in a manner that is helpful to consumers. The report card also includes the results of a survey OPA sent to HMOs that describes how HMOs provide services to enrollees who do not speak English as their first language, or are hearing impaired.
Although you purchase your health care insurance through your HMO, a doctor who works with a medical group provides the health care you receive. HMOs contract with medical groups to care for members such as you who sign up with HMOs. That's why the Report Card includes ratings of HMOs' medical care and service, and of the medical groups who contract with them. HMOs and medical groups have different strengths and weaknesses, so OPA's goal is to provide California health care consumers with information to compare HMOs and medical groups and make the choices that best suit their needs.