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California HMO Report Card: Promoting Standardized Health Plan Quality Information Problem: In 2000, California legislation established the new Office of the Patient Advocate (OPA) at the same time it founded the new Department of Managed Health Care (DMHC) and directed it to create a health plan report card. Implementation of this requirement created the opportunity for an important new tool for consumers. A coordinated quality measurement and reporting systems avoids redundancy and minimizes additional resource burden for health plans and provider groups.  PBGH
Role and Project Description: PBGH serves as a private partner under subcontract to the State of California in engaging consumers to be "smart shoppers" for health care. PBGH built Web-based and print HMO quality reports for the OPA to communicate to consumers statewide about health plan quality. As the principal collaborator on the HMO Report Card, PBGH leveraged the pioneering work it has done on HealthScope and the existing data collection infrastructure of the California Cooperative Healthcare Reporting Initiative (CCHRI) to help the state launch a report card that is accurate, relevant, user-friendly and easy to understand. The completed Web site was transferred to the state in September 2001. In addition, printed report cards (in English, Spanish, Chinese, Vietnamese and Korean) are available.Impact: By helping the State create a standard HMO quality report format to communicate performance that bridges the public and private sectors in California, the partnership between PBGH and the OPA means that California built on current valid work and did not create new, costly data collection demands or confusing public reports. Many more consumers across California will see this important standardized comparative information on health plans. The information will spur growing consumer expectations about quality performance, which in turn will motivate the industry to improve quality. Increased consumer awareness of such information places more pressure on the health plans to improve their performance. Recently, the OPA's quality report expanded to include medical group performance information. Current Activities: PBGH has successfully bid to assist with the current annual update of the State of California HMO Report Card. This marks the sixth year that PBGH has worked with the Office of the Patient Advocate to provide Californians with a single, standard set of quality performance ratings of health plans and medical groups. PBGH has also coordinated plan surveys on health plan language support and translation services to support the health care needs of diverse populations. PBGH and the OPA are working together with CCHRI to maintain standard performance ratings and standard consumer information presentations so that all Californians, whether in the workplace, home or elsewhere, can use a common information set to consider quality performance in their health plan and provider choices. The annual update to the OPA report card is available in late September. |
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