All Quality of Care Improves for California Consumers
California HMO and Medical Group Ratings Released

San Francisco, CA, September 25, 2000 – The Pacific Business Group on Health (PBGH) and California Cooperative HealthCare Reporting Initiative (CCHRI) today announced new data showing improvement in the overall quality of care for California consumers. The groups also released new quality ratings for HMOs and medical groups throughout the state.

"There are clear differences in the quality of health care provided by HMOs and medical groups in California. By using the quality ratings, consumers can help identify which plans and groups will provide them with the highest quality care and the greatest value," said Peter Lee, PBGH President and CEO. Quality ratings can be found in the newest version of PBGH's HealthScope, a guide designed to help consumers make the best decisions at all levels at which their care is delivered. Ratings can be accessed at HealthScope.org.

In addition to consumer ratings of care, preventive services, and access to specialty care, this year's HealthScope rates comprehensive diabetes care, appropriate medication for people with asthma and chlamydia screening in women. HealthScope also includes medical group ratings over time and data on the volume of procedures done in California hospitals–greater volume is linked to better patient outcomes.

The overall consumer rating of California health plans has improved–for 12 out of 15 plans. The data also reveals that:

• 58% of consumers rate their California health plans as an 8, 9 or 10 on a scale of 0-10, with 10 the best score, compared to a national HMO average of 56.7% as reported by the National Committee for Quality Assurance (NCQA).
• The vast majority of HMO members receive care quickly: HMO members can obtain an appointment with their primary care physician within 3 days or less 69% of the time and 86% within 7 days.
• 86% of HMO members think their doctors communicate well and 70% feel they always or usually receive the medical care they need.

Additionally, HMO use of beta blockers–effective, low cost drugs that have been shown to reduce morbidity and mortality associated with heart disease, as well as the chance of second heart attack–has increased. Average California health plan use of beta blockers is 88%, compared to a national average of 85%. Both national and California scores have improved since 1996-1997 when CCHRI results reported California use of beta blockers at 75% and 62% use nationwide.

When dealing with Medicare HMO enrollees, California health plans performed better this year on several measures. Use of beta blockers was rated 90%, as opposed to 76% two years ago, and mammography screening was rated 75% – an increase from 71%.

HealthScope data is provided by CCHRI, a unique statewide collaboration of health care purchasers, plans and providers. Information is collected from health plans representing 95% of all commercial HMO enrollment in California and standardized in an easy-to-use report card on health plan performance. David Hopkins PhD, who heads the CCHRI Executive Committee, said, "Collaboration is crucial to improving the quality of care provided by health plans and providers."

"Not only are we seeing improvement in clinical performance and patient service, but also that a commitment to collect and report the data significantly effects performance," said Lee. "These health plans are willing to step up and be counted–an essential element in promoting accountability."

"The CCHRI results document that health plans are making an impact in improving coordinated care and patient outcomes," said Dr. Jeff Kamil, Vice President of Quality Management at Blue Cross of California's Medical Department. "Although participation requires significant resources, it is important for our industry to continue to support quality measurement and continuous quality improvement."

"PBGH, through HealthScope, is considered a leader in consumer-friendly outreach on the important health care quality issues in California," said Ann F. Monroe, director of the California HealthCare Foundation Quality Initiative. "We are pleased to be a partner and fund the publicizing of HealthScope."

Consumers viewing HealthScope online can create their own report cards on health plans, medical groups and hospitals and access physicians by office location, health plan affiliation, specialty and years in practice. "As more and more people turn to the Internet for guidance, there is increasing demand for specific and quality information on health care services and individual doctors," said PBGH Director of Quality, Cheryl Damberg.

Pacific Business Group on Health (PBGH), a major business coalition of 45 large purchasers, is dedicated to value based purchasing–improving health care quality while moderating cost. Our members annually spend more than $3 billion to provide health coverage to approximately 3 million employees, retirees and their families. PBGH seeks to promote health plan and provider accountability and provide consumers with standardized, comparable data to make the best health care decisions at all levels of care. PBGH also operates PacAdvantage, a small group purchasing pool providing health insurance to more than 9,500 small businesses in California, also known as the Health Insurance Plan of California (HIPC).

The dissemination of the printed version of California Consumer HealthScope was made possible in part with support from the Quality Initiative of the California HealthCare Foundation. The Quality Initiative underwrote a portion of PBGH's costs for transit ads in the Bay Area and Sacramento, as well as mailing and production costs for HealthScope materials.

Contact:
Clark Miller
Senior Communications Manager
Pacific Business Group on Health
Telephone: (415) 615–6302
E–mail: cmiller@pbgh.org

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