Poizner turns heat up on health insurance companies

November 18, 2010 12:00:00 AM PST
As the nation debates the future of health care, California's insurance commissioner is trying to turn up the heat.

Steve Poizner is pushing for better care by publicizing performance ratings for the leading HMO's and PPO's in the state.

"This is a wake-up call. Some of the results are atrocious," he said Thursday.

For the 2.5 million Californians who have a Preferred Provider Organization (PPO) for health insurance, a new report card by the California Department of Insurance may open the door for better care and service. None of the six companies received the highest rating of four stars. They were mostly in the mediocre range of two to three stars.

"It's now time for everyone to put a lot of pressure on health insurance companies. They better step up and improve," Poizner said.

Among the worst performers when it comes to meeting the national standard of care and providing good customer service, were Anthem Blue Cross, Blue Shield of California, Blue Shield Life and Health Net. They got a "fair" rating with only two stars. When it came to service, they were at the bottom joining United Healthcare and Cigna with one star, considered a "poor" rating.

Most PPO insurance companies had not reviewed the report card yet, but United HealthCare and Aetna said they are committed to improving service.

"I just saw your list and I was astonished. My God," PPO member Wyatt Earp said.

ABC7 showed PPO members the ratings and they say they are consistent with their experience.

"On the phone, they ask who it is and I have to repeat everything I just said to some other girl when she transfers me to somebody else," Earp says.

Some people say they do not understand all the letters insurance companies send.

"I think the companies need to do a better job on explaining things and they have all these crazy codes that you don't know what they are," says PPO member Leslie Clemons.

Healthcare advocates may start pushing insurance companies to be more clear.

"So that customers have better information, they have clearer standards, and they have more transparency so they can make purchasing decisions when they're deciding between plans," says Anthony Wright with Health Access California.

On a positive note, the report found that 8 out of every 10 PPO members had a favorable experience with their plan, and that two-thirds of patients are getting the right care for their condition.


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