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California HMO/POS plans vs. the National Average

What Was Measured?

This page contains the average of the scores of California’s largest HMO and point of service (POS) health plans on 26 National Committee for Quality Assurance (NCQA) HEDIS clinical quality measures in 2005, compared to the average for HMO and POS plans across the nation. The California plans used for this analysis were Aetna, Blue Cross, Blue Shield, Cigna, Health Net, Kaiser, Pacificare, and Western. The national average includes all of the health plans from California. The averages were calculated giving equal weight to each HMO/POS score. Weighting the California and national HMO/POS scores by the number of enrollees per health plan would result in different scores.

Why Is It Important?

Everyone would like to think that the quality of care they receive is the best in the country. Comparing California HMO/POS scores to national averages shows us where we are doing well, and where there are opportunities to improve. The averages also indicate what health care services representing high quality care you are most likely to receive, and what services are performed less frequently.

What Was the Source?

NCQA collects and reports on HEDIS quality of care measures as part of the voluntary accreditation process for HMOs. Data on HMO and POS enrollees voluntarily reported by California health plans to the National Committee for Quality Assurance (NCQA) is made available through NCQA’s Quality Compass®. This comparison of California HMO/POS healthplans to national averages was compiled from data publicly reported in the NCQA 2005 Quality Compass®. HMO and POS data are reported together here because Quality Compass® does not separate HMO and POS membership in it’s report. The 2005 HEDIS averages contained in this section differ from the 2006 HEDIS and CAHPS quality information found in the remainder of the 2006 Healthcare Quality Report Card.

California HMO/POS Healthplans vs. the National Average in 2005 | About the HMO Ratings

 

California Average:

California HMO/POS plans scored on meeting national standards of care

National Average:

National HMO/POS plans scored on meeting national standards of care
Visits After Giving Birth 81% 80%
Visits During Pregnancy 93% 90%
Anti-depressant Medication — Initial Treatment 22% 18%
Anti-depressant Medication — Ongoing Treatment 47% 44%
Follow-up Visit After Mental Illness Hospital Stay 74% 75%
Treatment Visits for Depression 64% 60%
Chlamydia Screening Age 16-20 37% 36%
Chlamydia Screening Age 21-25 39% 35%
Child Immunizations 77% 76%
Teenage Immunizations 68% 60%
Treating Children with Throat Infections 47% 67%
Treating Children with Upper Respiratory Infections 83% 83%