Healthcare providers criticize Covered California over quality ratings

7:26 PM, Oct 23, 2013   |    comments
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SACRAMENTO, CA - Health providers are criticizing Covered California for not posting quality ratings about specific insurance plans.

"We score very high in those quality metrics across the board," Western Health Exchange spokesperson Rick Heron said.

Heron said the ratings - which score physician and hospital services and overall customer satisfaction - help consumers choose one plan over the other. In fact, Heron said data shows consumers will pay more for a higher rated product.

But, Covered California wants to postpone publishing those ratings while consumers shop for health plans in 2014.

"You run into a problem of comparing apples to apples," Covered California spokesperson Anne Gonzales said.

Gonzales said 70 percent of plans in the state's healthcare exchange program are new and have no historical data.

"From those plans who are currently in the commercial market, we would only be able to post plans of four of the 12, and we're not sure if that would be appropriate or fair to the consumer," Gonzales said.

The federal government will eventually require that all states publish consumer ratings, but has not set a deadline.

As the exchange passes through the next couple of years, Covered California wants to collect their own data from consumers using the new system, then publish all of the ratings at once. Gonzales said they are aiming for October 2015 to publish consumer ratings.

"We wanted to not be misleading and make sure we give them a clear picture," Gonzales said.

However, Western Health Exchange said the state is being misleading by withholding information from consumers.

"We believe, right next to the price should be a quality rating, and we believe that will give consumers a full picture of what they're choosing," Heron said.

Kaiser Permanente is also criticized the state's position.

"We hope Covered California will agree to display this information, so consumers have the best, and most accurate information on which to base their decisions," Kaiser Permanente said in a statement.

Covered California staff will recommend to the board, in a meeting Thursday, to postpone publishing the ratings until the program has collected consumer data from all plans.


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