Are You Getting Good Care?
During the last several years, researchers have begun to ask consumers across the country about their experiences with health plans and with the physician groups with which the plans contract to deliver care. How often do you get the care you need? How timely is it? How long do you have to wait to see a doctor? How often do you have trouble getting in to see a specialist? The answers to these questions are used to chart broad comparisons of health plans and doctors’ groups.
The surveys have prompted providers and insurers to improve services, some researchers believe. “Over the past few years, in HMOs we’ve seen steady improvement in several measures,” including treatment of high cholesterol and diabetes, says Clark Miller, a spokesman for the Pacific Business Group on Health, an alliance of some of California’s biggest employers, which helped develop the HMO Report Card and the Medical Group Performance Scores chart.
Both tables offer crude, overall measures of performance and should be considered only a first step in judging a health plan or physicians’ group, Miller says. More detailed information on HMOs and physician groups will soon be available on the business group’s Web site, https://healthscope.org.
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California HMO Report Card
Key: POOR ( 0 ); FAIR ( 1 ); GOOD ( 2 ); EXCELLENT ( 3 )
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Living Doctor Staying Getting With Communicn Plan Healthy Better illness & Service Service Aetna U.S. Healthcare-South 2 2 2 2 1 Blue Cross of Cal. HMO-California Care 2 2 1 2 1 Blue Shield of California HMO 2 2 1 2 1 CIGNA HealthCare of California 2 2 2 2 1 Health Net of California 2 2 1 2 2 Inter Valley Hlth Plan 1 (a) 1 2 1 Kaiser Permanente- South 2 2 2 2 2 Maxicare (1) 1 1 1 2 1 PacifiCare of California 2 2 1 2 1 Universal Care (a) (a) (a) 2 1
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Source: Compiled from 2000 patient surveys, administrative records and medical records. Courtesy: State of California; Office of the Patient Advocate; Business, Transportation and Housing Agency
(1) Due to financial problems, HMO is now being run by state regulators.
(a) No info
(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)
Consumer Ratings of Medical Groups
In 2001, patients in Southern California medical groups were surveyed to find out how they rated the quality of care they receive in their medical groups. Questions addressed patient satisfaction with care, the ease of getting referrals to specialists, quality of care for routine and serious illness or injuries, and how well doctors provided recommended preventive care.
Average Score for Southern California Groups
Health Care From Doctors: 66
Getting Needed Care: 70
Getting Care Quickly: 73
Doctor-Patient Communication: 85
No Problem Getting Necessary Care: 68
Waited 30 Minutes or Less in Doctor’s Office: 70
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 74
No Problem Seeing Specialist When Needed: 60
*
Adventist Health So. Calif. Medical Foundation
Health Care From Doctors: 58(w)
Getting Needed Care: 64 (w)
Getting Care Quickly: 66 (w)
Doctor-Patient Communication: 83
No Problem Getting Necessary Care: 65
Waited 30 Minutes or Less in Doctor’s Office: 44 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 69
No Problem Seeing Specialist When Needed: 63
*
Alliance/Unified Medical Group
Health Care From Doctors: 72(b)
Getting Needed Care: 72
Getting Care Quickly: 75
Doctor-Patient Communication: 85
No Problem Getting Necessary Care: 73
Waited 30 Minutes or Less in Doctor’s Office: 67
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 77
No Problem Seeing Specialist When Needed: 60
*
Beaver Medical Group
Health Care From Doctors: 72(b)
Getting Needed Care: 76(b)
Getting Care Quickly: 72
Doctor-Patient Communication: 87
No Problem Getting Necessary Care: 74(b)
Waited 30 Minutes or Less in Doctor’s Office: 73
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 71
No Problem Seeing Specialist When Needed: 56
*
Bright Medical Associates
Health Care From Doctors: 63
Getting Needed Care: 73
Getting Care Quickly: 69 (w)
Doctor-Patient Communication: 86
No Problem Getting Necessary Care: 70
Waited 30 Minutes or Less in Doctor’s Office: 55 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 75
No Problem Seeing Specialist When Needed: 63
*
Bristol Park Medical Group
Health Care From Doctors: 67
Getting Needed Care: 74
Getting Care Quickly: 76
Doctor-Patient Communication: 85
No Problem Getting Necessary Care: 70
Waited 30 Minutes or Less in Doctor’s Office: 78(b)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 67
No Problem Seeing Specialist When Needed: 53
*
Caremore Medical Group
Health Care From Doctors: 67
Getting Needed Care: 70
Getting Care Quickly: 75
Doctor-Patient Communication: 88(b)
No Problem Getting Necessary Care: 68
Waited 30 Minutes or Less in Doctor’s Office: 55 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 79
No Problem Seeing Specialist When Needed: 61
*
Cedars-Sinai Health Associates
Health Care From Doctors: 64
Getting Needed Care: 67
Getting Care Quickly: 73
Doctor-Patient Communication: 77 (w)
No Problem Getting Necessary Care: 65
Waited 30 Minutes or Less in Doctor’s Office: 76
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 73
No Problem Seeing Specialist When Needed: 67
*
Cedars-Sinai Medical Group
Health Care From Doctors: 70
Getting Needed Care: 70
Getting Care Quickly: 74
Doctor-Patient Communication: 80
No Problem Getting Necessary Care: 69
Waited 30 Minutes or Less in Doctor’s Office: 81(b)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 70
No Problem Seeing Specialist When Needed: 60
*
Facey Medical Group
Health Care From Doctors: 59 (w)
Getting Needed Care: 67
Getting Care Quickly: 64 (w)
Doctor-Patient Communication: 82
No Problem Getting Necessary Care: 68
Waited 30 Minutes or Less in Doctor’s Office: 65
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 64 (w)
No Problem Seeing Specialist When Needed: 54
*
Good Samaritan Medical Practice Assn.
Health Care From Doctors: 76(b)
Getting Needed Care: 70
Getting Care Quickly: 78(b)
Doctor-Patient Communication: 86
No Problem Getting Necessary Care: 62
Waited 30 Minutes or Less in Doctor’s Office: 70
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 80
No Problem Seeing Specialist When Needed: 59
*
Greater Newport Physicians
Health Care From Doctors: 67
Getting Needed Care: 74
Getting Care Quickly: 78(b)
Doctor-Patient Communication: 85
No Problem Getting Necessary Care: 75(b)
Waited 30 Minutes or Less in Doctor’s Office: 71
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 83(b)
No Problem Seeing Specialist When Needed: 61
*
Greater Valley Medical Group
Health Care From Doctors: 58 (w)
Getting Needed Care: 67
Getting Care Quickly: 65 (w)
Doctor-Patient Communication: 84
No Problem Getting Necessary Care: 63
Waited 30 Minutes or Less in Doctor’s Office: 59 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 68
No Problem Seeing Specialist When Needed: 57
*
Greater Valley IPA
Health Care From Doctors: 53 (w)
Getting Needed Care: 59 (w)
Getting Care Quickly: 67 (w)
Doctor-Patient Communication: 74 (w)
No Problem Getting Necessary Care: 55 (w)
Waited 30 Minutes or Less in Doctor’s Office: 70
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 64 (w)
No Problem Seeing Specialist When Needed: 50 (w)
*
HealthCare Partners Medical Group
Health Care From Doctors: 76(b)
Getting Needed Care: 78(b)
Getting Care Quickly: 81(b)
Doctor-Patient Communication: 89(b)
No Problem Getting Necessary Care: 78(b)
Waited 30 Minutes or Less in Doctor’s Office: 77(b)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 83(b)
No Problem Seeing Specialist When Needed: 70(b)
*
Lakeside Medical Group
Health Care From Doctors: 65
Getting Needed Care: 72
Getting Care Quickly: 75
Doctor-Patient Communication: 84
No Problem Getting Necessary Care: 70
Waited 30 Minutes or Less in Doctor’s Office: 67
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 77
No Problem Seeing Specialist When Needed: 64
*
Lakewood Health Plan Inc.
Health Care From Doctors: 63
Getting Needed Care: 69
Getting Care Quickly: 72
Doctor-Patient Communication: 82
No Problem Getting Necessary Care: 65
Waited 30 Minutes or Less in Doctor’s Office: 67
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 70
No Problem Seeing Specialist When Needed: 61
*
Memorial Healthcare IPA
Health Care From Doctors: 67
Getting Needed Care: 70
Getting Care Quickly: 75
Doctor-Patient Communication: 86
No Problem Getting Necessary Care: 66
Waited 30 Minutes or Less in Doctor’s Office: 62 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 76
No Problem Seeing Specialist When Needed: 67
*
Northridge Medical Group
Health Care From Doctors: 55 (w)
Getting Needed Care: 62 (w)
Getting Care Quickly: 68 (w)
Doctor-Patient Communication: 80 (w)
No Problem Getting Necessary Care: 59 (w)
Waited 30 Minutes or Less in Doctor’s Office: 60 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 68
No Problem Seeing Specialist When Needed: 50 (w)
*
Omnicare Medical Group
Health Care From Doctors: 71
Getting Needed Care: 65
Getting Care Quickly: 67 (w)
Doctor-Patient Communication: 81
No Problem Getting Necessary Care: 65
Waited 30 Minutes or Less in Doctor’s Office: 50 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 75
No Problem Seeing Specialist When Needed: 53
*
Physician Associates of San Gabriel Valley
Health Care From Doctors: 65
Getting Needed Care: 64 (w)
Getting Care Quickly: 72
Doctor-Patient Communication: 81
No Problem Getting Necessary Care: 57 (w)
Waited 30 Minutes or Less in Doctor’s Office: 58 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 83(b)
No Problem Seeing Specialist When Needed: 51 (w)
*
Prime Care Medical Group Network
Health Care From Doctors: 66
Getting Needed Care: 72
Getting Care Quickly: 74
Doctor-Patient Communication: 84
No Problem Getting Necessary Care: 70
Waited 30 Minutes or Less in Doctor’s Office: 60 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 72
No Problem Seeing Specialist When Needed: 60
*
Sea View Medical Group
Health Care From Doctors: 70
Getting Needed Care: 73
Getting Care Quickly: 79(b)
Doctor-Patient Communication: 86
No Problem Getting Necessary Care: 68
Waited 30 Minutes or Less in Doctor’s Office: 74
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 82(b)
No Problem Seeing Specialist When Needed: 57
*
Kaiser-So. Calif. Permanente Medical Group
Health Care From Doctors: 68
Getting Needed Care: 72
Getting Care Quickly: 74
Doctor-Patient Communication: 85
No Problem Getting Necessary Care: 67
Waited 30 Minutes or Less in Doctor’s Office: 78(b)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 77
No Problem Seeing Specialist When Needed: 58
*
St. Joseph’s Heritage Medical Group
Health Care From Doctors: 70
Getting Needed Care: 74
Getting Care Quickly: 75
Doctor-Patient Communication: 87
No Problem Getting Necessary Care: 73
Waited 30 Minutes or Less in Doctor’s Office: 66
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 78
No Problem Seeing Specialist When Needed: 64
*
Talbert Medical Group
Health Care From Doctors: 62
Getting Needed Care: 72
Getting Care Quickly: 72
Doctor-Patient Communication: 83
No Problem Getting Necessary Care: 69
Waited 30 Minutes or Less in Doctor’s Office: 70
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 71
No Problem Seeing Specialist When Needed: 58
*
Torrance Hospital IPA
Health Care From Doctors: 65
Getting Needed Care: 73
Getting Care Quickly: 76
Doctor-Patient Communication: 83
No Problem Getting Necessary Care: 68
Waited 30 Minutes or Less in Doctor’s Office: 63 (w)
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 81
No Problem Seeing Specialist When Needed: 65
*
UCLA Medical Group
Health Care From Doctors: 67
Getting Needed Care: 64 (w)
Getting Care Quickly: 72
Doctor-Patient Communication: 88(b)
No Problem Getting Necessary Care: 65
Waited 30 Minutes or Less in Doctor’s Office: 72
Got Illness/Injury Care From Primary Care Physician as Soon as Wanted: 75
No Problem Seeing Specialist When Needed: 56
*
How to read the performance scores:
(b) = Significantly better than average; (w) = Significantly worse than average.
Note: Each medical group’s score is compared with the average score for all groups in Southern California to determine whether the group’s performance is significantly better or worse than the regional average performance of medical groups. The scores come from more than 12,000 HMO members who were asked to rate the care they received from doctors in their medical groups.
Source: Pacific Business Group on Health and the CCHRI California Assessment Survey,2001
