HMO members more satisfied in 2009
Although health maintenance organizations in California need to improve screenings for cancer and other medical conditions, most receive high marks for customer satisfaction, a new state report said Tuesday.
Six of California’s nine largest HMOs earned higher patient approval ratings in 2009 than they did the year before, say officials from the Office of the Patient Advocate, a state agency that issues an annual report card to help consumers evaluate health coverage. The report is based on 2008 data.
Kaiser Permanente’s Southern California region, which serves 3.2 million people, received the highest rating -- four stars out of a possible four -- for its medical care and patient satisfaction. Kaiser Permanente’s Northern California arm earned four stars for patient care, while PacifiCare of California and Western Health Advantage each received four stars for patient satisfaction.
HMOs serve nearly 21 million people in the state.
Kaiser executives attributed their high rankings partly to the use of electronic medical records, which keep track of medical tests, follow patients from one doctor to another and make information available via home computers.
The technology, along with stepped-up efforts to screen patients for such ailments as breast cancer and osteoporosis, have helped the Kaiser systems better coordinate care, the HMO said.
“All this is raising our quality and lowering our costs,” said Dr. Jeffrey Weisz, executive medical director of Kaiser’s Southern California Medical Group. “Prevention is the answer to the healthcare crisis in America.”
Sandra Perez, director of the state’s patient advocacy agency, said the report card showed that HMOs were paying closer attention to consumers’ needs. But Perez also said that HMOs needed to do a better job of providing care for certain conditions.
She pointed out, for example, that just 57% of HMO members between the ages of 50 and 80 were tested in 2008 for colorectal cancer, a disease that can often be cured if detected early. Fifty-three percent of Aetna members in this group, and 55% of Western Health Advantage patients in the age range, were tested.
In addition, nearly half of children insured through HMOs “wrongly” received antibiotics during this time for sore throats without first having cultures to verify infections, the report said.
And although screening for the sexually transmitted disease chlamydia has increased over the last five years, less than half of sexually active women between 16 and 24 were tested in 2008. The condition, if left untreated, can lead to complications such as pelvic inflammatory disease, which can interfere with the ability to become pregnant.
“There is a lot of room for improvement,” Perez said of the results.
To review the report cards, go to www.opa.ca .gov.
The report card allows consumers to compare how well health plans use personal medical records and address conditions such as asthma, arthritis and diabetes. In addition, it provides information about medical groups in California.
“We want patients to become active partners in their healthcare,” Perez said. “If patients begin to pay attention to the quality of care provided by their health plans, they can ask and demand the care they need.”
