California PPO Plans Compared to Health Plans Nationwide
   PPO Ratings Need help?
Call our Consumer Hotline at 1-800-927-HELP (4357)
 

California PPO Plans Compared to PPO Health Plans Nationwide

What do the scores mean?

California's largest PPO health plans' quality scores are compared to results of PPO health plans throughout the U.S. A set of standard quality measures are used to compare the average performance among PPOs in California to the PPO national average and to the best performing plans in the country — the 90th percentile results are scores that are better than 90 percent of all reporting PPO health plans' results nationwide. These scores largely are based on patient care provided in 2014.

The California plans' scores are the average across California PPOs. The nationwide results are from PPO health plans located throughout the U.S. and were calculated giving equal weight to each plan's score regardless of its number of enrollees.

What Is the Source?

The National Committee for Quality Assurance (NCQA) collects and reports on HEDIS quality of care measures as part of its nationwide health plan accreditation program. These nationwide health plan results include scores from PPO plans. This comparison of California health plans to national scores uses data that was reported in the NCQA 2015 Quality Compass®.
 
  California Average:
California PPO Plans
National Average:
PPO Plans Nationwide
National 90th Percentile:
Top PPO Plans Nationwide
Asthma Medicine for Adults/Adolescents 78% 77% 84%
Asthma Medicine for Children 87% 87% 95%
Testing Lung Disease 35% 41% 50%
Treating Lung Disease – Corticosteroid Medication 68% 70% 81%
Treating Lung Disease – Bronchodilator Medication 78% 76% 86%
Treating Bronchitis: Getting the Right Care 35% 28% 39%
Breast Cancer Screening 74% 71% 80%
Cervical Cancer Screening 75% 74% 81%
Colorectal Cancer Screening 64% 60% 72%
Chlamydia Screening Age 16-20 48% 41% 58%
Chlamydia Screening Age 21-24 59% 51% 66%
Eye Exam for Diabetes Patients 49% 51% 68%
Testing Blood Sugar for People with Diabetes 90% 90% 94%
Controlling Blood Sugar for Diabetes Patients 59% 51% 65%
Testing Kidney Function for Diabetes Patients 90% 89% 93%
Controlling Blood Pressure For Diabetes Patients 65% 56% 76%
Doctor Advises Patient to Quit Smoking 0% 74% 83%
Heart Attack Medication 81% 84% 92%
Controlling High Blood Pressure 60% 59% 75%
Visits During Pregnancy 85% 81% 95%
Visits After Giving Birth 74% 70% 88%
Alcohol and Drug Dependence Treatment – Initiation Phase 31% 34% 41%
Alcohol and Drug Dependence Treatment – Ongoing Phase 10% 12% 17%
Antidepressant Medication – First three Months of Treatment 64% 68% 76%
Antidepressant Medication – Six Months Continuation of Treatment 48% 52% 60%
Follow-up Visit Within 7 Days After Mental Illness Hospital Stay 57% 52% 67%
Follow-up Visit Within 30 Days After Mental Illness Hospital Stay 72% 71% 82%
Preventing Hospital Readmission After Discharge 0% 0% 0%
Testing for Cause of Back Pain 79% 74% 82%
Checking if Weight Could Cause Health Problems 80% 70% 92%
Flu Shots for Adults 48% 48% 59%
Treating Arthritis With Medications 86% 87% 93%
Giving Lab Tests for Patients Taking Medications for a Long Time 83% 83% 87%
Immunizations for Children 51% 48% 65%
Immunizations for Early Teens 22% 14% 21%
Checking If Children's Weight Could Cause Health Problems 67% 60% 87%
Checking if Adolescent's Weight Could Cause Health Problems 64% 57% 84%
Treating Children with Throat Infections 76% 84% 93%
Treating Children with Upper Respiratory Infections 93% 88% 95%
Starting Care for Attention Deficit Hyperactivity Disorder 38% 39% 50%
Ongoing Care for Attention Deficit Disorder 44% 46% 57%