What is Quality Health Care?

Choosing Quality

Report Cards on quality provide important information to help you make choices to improve the quality of your own care.

Much of this information is right at your fingertips in the online Health Care Quality Report Cards. These Report Cards show health care quality and patient satisfaction ratings for health plans and medical groups in California.

When choosing a health plan

Be sure to factor in quality in order to get the best value. You can use the Health Care Quality Report Cards to compare ratings for California’s largest HMO and PPO plans.

When choosing a provider or medical group

Pay attention to both quality and cost to get the best value. If your doctor is part of a medical group, you will typically get referrals to see specialists and other providers within this medical group. Select your county to compare quality and cost ratings for medical groups in your area.

To use the cost ratings when choosing a medical group

Generally, you want to try to get the best quality care at the lowest cost. The cost ratings are based on the average payment made by the patient and the patient’s health plan for care. Independent research shows that medical groups that receive higher payments do not necessarily provide higher quality care.

Choosing a medical group that receives higher payments may mean that you will pay more to get medical care.

• When prices are higher, you may pay more for care before meeting your deductible or for your co-insurance share of a medical bill.
• The actual amount that you pay out-of-pocket depends on the details of your insurance policy or health plan.

If a health plan or medical group does not score well on quality

You can still get quality care from a low-scoring health plan or medical group. You may need to work more closely with your doctor and health plan to make sure you are getting the right care.

• A good starting point is to look at what care is recommended under the different health topics within the Report Cards.
• Talk to your doctor about what care is right for you.
• Contact your health plan’s member services if you are having problems using your plan.

To learn more about recommended care

You can click the “read more” link within the various health topics on the online Report Cards to find out more about what care is recommended. Talk with your doctor to decide what care is right for you.