Most Popular Stories
- Hospital faces 100+ lawsuits; NYC plagued with poor patient safety
- MGMA urges changes in ICD-10 implementation approach
- Transitional care life coaches, clinics save hospitals thousands
- 6 keys to successful mobile medical apps
- Hospital CIOs not hesitant to use consultants for IT projects
- Bill aims to train more residents as docs retire
Events
- IHI's Transforming the Primary Care Practice
May 1-3, 2012 — San Diego, CA - IHI Triple Aim Seminar
April 11-12, 2012 — San Diego, CA - IBM REPORT: Predicting treatment outcomes
- 3rd Healthcare IT Innovation Asia
Mar 14-15 2012 — Singapore
Paid Research Reports
-
Electronic health records: getting it right first time
-
Cloud Computing Adoption In The APAC Life Sciences Industry
-
Stakeholder Opinions: Ophthalmology - Leading brands under threat
-
Genomics, Proteomics and Metabolomics in Diagnostics: Market landscape, innovative technologies and future outlook
-
Healthcare Regulatory Update: The United Arab Emirates
-
Point of Care Testing: Evaluating the return to evidence based medicine, novel technologies and the competitive landscape
Free Newsletter
Free Newsletter
FierceHealthPayer provides the latest news about the fast-changing and heavily regulated area of healthcare reimbursement. Join 16,000 healthcare plan executives who get FierceHealthPayer via twice weekly email. Sign up today!
Top Tags
Insurers improve diabetes care, get low marks for other coverage
California's health plans received positive marks for customer satisfaction and enhanced diabetes care, but they still should improve treatment for lung disease, attention-deficit disorder and throat infections in children, according to a state report card.
The report, which the California Office of the Patient Advocate released Wednesday, rated California's nine largest HMOs, six largest preferred provider organizations (PPOs) and medical groups across the state, reported the Los Angeles Times.
Garnering the highest scores was Kaiser Permanente, which received the top ranking of four stars in most categories. Kaiser attributed its lead status to its integrated healthcare delivery system that allows primary care doctors and specialists jointly to oversee patients so they "don't fall through the cracks," said Robert Pearl, executive director and CEO of the Permanente Medical Group. He added that because Kaiser patients prepay for their care, the insurer is motivated to deliver appropriate care and keep patients healthy instead of rewarding doctors for volume, according to the San Jose Mercury News.
Overall, the report shows California HMOs exceeded 2010 national averages for diabetes care and improved heart care, including controlling high blood pressure and cholesterol. PPOs fell behind national averages for many categories, including eye exams for diabetes patients and administering heart attack medication, the Ventura County Star reported.
For the categories of customer service helpfulness, providing cost information and paying claims correctly, five HMOs and four PPOs received poor ratings. Office of the Patient Advocate Director Sandra Perez said the confusion often centers around copayments and changes in cost-sharing each year.
This annual report card often leads to positive changes throughout California health plans. "Surveys like this are certainly helpful because they give us a good snapshot of what we're doing well and identify areas where we can improve," Health Net spokesman Brad Kieffer said.
Anthem Blue Cross, whose HMO plan received three stars for several quality of care measures, said it will examine the data to determine how it can better serve members. However, spokesman Darrel Ng noted that the lower scores for Anthem Blue Cross' PPO plan are "not truly reflective of the excellent service our members received due to data issues that have been identified and will be resolved in time for next year's report card."
To learn more:
- access the California health plan ratings
- read the Los Angeles Times article
- see the San Jose Mercury News article
- check out the Ventura County Star article
Related Articles:
Survey: Health insurance industry has worst customer service
Insurers: Wake up and smell members' service expectations
Survey: Members will pay more for better customer service
Kaiser Permanente doctor imparts how to prevent childhood obesity
Kaiser pays cash when members lose weight
Home | Subscribe | Advertise | Mobile Edition | RSS | Privacy | Site Map | EditorsTHE FIERCEMARKETS NETWORKFierceEnergy | FierceSmartGrid | FierceFinance | FierceFinanceIT | FierceComplianceIT | FierceHealthcare | FierceHealthFinance | FierceHealthIT | Hospital Impact | FierceMobileHealthcare | FierceHealthPayer | FiercePracticeManagement | FierceEMR | FierceCIO | FierceCIO:TechWatch | FierceContentManagement | FierceMobileIT | FierceGovernmentIT | FierceGovernment | FierceHomelandSecurity | FierceBiotech | FierceBiotech Research | FiercePharma | FierceVaccines | FierceBiotechIT | FiercePharma Manufacturing | FierceMedicalDevices | FierceDrugDelivery | FierceCRO | FierceIPTV | FierceOnlineVideo | FierceTelecom | FierceEnterpriseCommunications | FierceBroadbandWireless | FierceDeveloper | FierceMobileContent | FierceWireless | FierceWireless:Europe | FierceCable© 2012 FierceMarkets. All rights reserved. |