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Member Contacts the State About HMO Concerns

What Was Measured?

The rate of contacts to the Department of Managed Health Care (DMHC) for California’s largest HMOs. The rate was determined by dividing the number of times an HMO member contacted the Department of Managed Health Care regarding a concern about their health care, by the number of HMO members within DMHC’s jurisdiction.

Why Is It Important?

Any HMO member, by law, can contact the State Department of Managed HealthCare (DMHC) if they are not satisfied with the way in which the HMO has handled a concern they have about their medical care or insurance. The rate of HMO member contacts to DMHC is one measure of how well HMOs meet their members needs and solve problems when they happen.

What Was the Source?

DMHC data including contacts to the DMHC Help Center, as well as the number of HMO members reported by HMOs to DMHC for the 2005 calendar year. For further information on the source of this data, please go to About the HMO Ratings.

DMHC Help Center Contacts in 2005

Contacts

Number of HMO Members

Rate of Contacts Per 10,000 HMO Members

Aetna Health of California Inc. 805  269,429  30 
Blue Cross HMO - CaliforniaCare 8,755  4,286,768  20 
Blue Shield of California HMO 8,303  2,405,652  35 
CIGNA HealthCare of CA 575  79,562  72 
Health Net of California, Inc. 3,051  1,935,220  16 
Kaiser Permanente - Northern and Southern California 5,630  5,807,167  10 
PacifiCare of California 1,983  1,289,000  15 
Western Health Advantage 92  79,953  12