Covered California Gives Kaiser Permanente's Health Plans Highest Quality Rating

Kaiser Permanente members brought in through Affordable Care Act receive life-saving treatment

News provided by

Nov 20, 2014, 03:18 ET

OAKLAND, Calif., Nov. 20, 2014 /PRNewswire/ -- When Diana Parret of Fresno lost her job, she also lost her health insurance. She hadn't seen a doctor in months, but the pain she felt in her abdomen every morning alerted her that something was wrong. She learned last spring that she qualified for a subsidy under the Affordable Care Act, and enrolled in a plan offered by Covered California, the state's health care exchange. Shortly after getting coverage, Kaiser Permanente diagnosed Diana with uterine cancer, and within weeks, she had surgery that left her cancer-free.

Of the health care exchange, she said: "I'm thankful, and it's a story I wanted to share because I think people need to know this works."

In Thousand Oaks, Thomas Stein had aged out of his parents' insurance coverage, and signed up for a Kaiser Permanente plan via Covered California. A suspicious lump on his neck turned out to be thyroid cancer. He, too, was promptly treated and his prognosis is good.

These are just two examples of newly insured Kaiser Permanente members, and among the thousands of similar individuals and families who were able to get insurance or improve their coverage with plans available through Covered California there likely are many more success stories.

All of Kaiser Permanente's plans on the exchange received 4 stars in the Covered California quality ratings – the highest score awarded.

"We approach quality health care as a responsibility to keep our members healthy and get them well when they're not," said Patrick Courneya, MD, executive vice president and chief medical officer for Kaiser Foundation Hospitals and Kaiser Foundation Health Plan. "Successful outcomes like those with Diana and Thomas are prevalent here at Kaiser Permanente. We are gratified that we are able to deliver our exceptional model of care to more people."

Now in its second year, Covered California opened 2015 enrollment on November 15. This year for the first time, shoppers in the exchange will be able to see quality ratings — along with prices and plan descriptions — laid out side by side on the site's "Shop and Compare" tool. Quality scores can currently be found on the website's "Plan Preview" section, as well as in the actual application at the point of plan selection.

The Covered California ratings represent nearly 50 nationally accepted measurements in four domains, including service, access to care, preventive care and clinical care. The scores include responses on such topics as a member's ability to get appointments, have their questions answered during those appointments, and receive the follow-up care they need to manage their conditions.

According to Covered California, a 4-star plan is placed in the top 25 percent of all rated plans. Three stars are given for those that landed in the 50-percent to 75-percent range, while a 2-star plan means it scored in the 25-percent to 50-percent range for all plans. One star is given for those plans scoring in the bottom 25 percent.

"We're proud of our Covered California Health Plan Quality ratings. We believe these ratings underscore the value Kaiser Permanente provides to our members," said Wade J. Overgaard, Kaiser Permanente's senior vice president for California Health Plan Operations. "We also applaud the type of competition Covered California promotes — giving consumers the ability to make apples-to-apples comparisons, without the fine print."

The scores were derived from the Consumer Assessment of Healthcare Providers and Systems, or CAHPS, a rating system used in other public reports such as the National Committee for Quality Assurance's "Health Insurance Plan Rankings."

"The real benefit of these scores goes directly to our members here in California," said Amy Compton Phillips, MD, chief quality officer, The Permanente Federation. "The scores reflect our consistently excellent performance and our dedicated physicians, nurses and care teams. Helping our members stay healthy — and treating them with compassion, knowledge and skill when they become ill — is what we strive to do every day."

For people shopping for coverage in the exchange, Kaiser Permanente's network for Covered California is the same broad and comprehensive system they provided to 7.5 million existing members in California. In other words, all Kaiser Permanente members — including those in Covered California — have access to Kaiser Permanente's extensive health care system. This includes access to more than 14,000 physicians in California and 35 hospitals from the San Francisco Bay Area and Los Angeles Basin to the Central Valley, and from Santa Rosa to San Diego.

Last month, Kaiser Permanente's Medicare health plans earned 5 stars — the highest overall rating for quality and service — from the Centers for Medicare & Medicaid Services. The California Office of the Patient Advocate also announced that Kaiser Permanente's health plans in both Northern California and Southern California were given 4-star ratings, again the highest possible rating, for overall quality of care and member satisfaction.

About Kaiser Permanente

Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve approximately 9.5 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.

Contact: Mark Camps 510-625-5624

Logo - http://photos.prnewswire.com/prnh/20130718/SF49717LOGO

SOURCE Kaiser Permanente