HMO & PPO 2016 Quality Ratings

​HMO Quality Ratings Summary

Quality health care is getting the right care at the right time. 

This Report Card shows the quality of health care for millions of Californians who get their care through commercial insurance provided by Health Maintenance Organizations (HMOs). The 10 largest HMOs in the state are included in this Report Card. 

The HMO Report Card includes health care quality scores for two major areas: 

• Clinical Performance Scores – The California Office of the Patient Advocate compared HMO members’ records in 2015 to a set of national standards for quality of care to make sure that health plans are offering quality preventive care and service to members.

• Patient Experience Scores – Members rated their ease for getting doctor appointments, tests and treatments during 2015. 

PPO Quality Ratings Summary

Quality health care is getting the right care at the right time. 

This Report Card shows the quality of health care for millions of Californians who get their care through commercial insurance provided by Preferred Provider Organizations (PPOs). The 5 largest PPOs in the state are included in this Report Card. 

The PPO Report Card includes health care quality scores for two major areas: 

• ​Clinical Performance Scores –The California Office of the Patient Advocate compared PPO members’ records in 2015 to a set of national standards for quality of care to make sure that health plans are offering quality preventive care and service to members.
  
• Patient Experience Scores –Members rated their ease for getting doctor appointments, tests and treatments during 2015.

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