CA managed care plans lack in preventive care

A new report suggests that California's managed care plans aren't doing a great job when it comes to preventive care. The California Office of the Patient Advocate has issued a report comparing how often the plans meet 31 clinical quality standards, such as appropriate rates of infant immunization and adult cancer screening, concluding that the health plans' compliance is low in some areas. For example, the report noted that almost one-third of middle-aged women hadn't had a mammogram within the last two-years and that half of members over 50 hadn't had colorectal cancer screens, though both are necessary in catching related cancers early and saving lives.

When rated on this basis, several of the states health plans were rated two out of four stars by the agency, including Aetna Health, Blue Cross, Blue Shield, Cigna, PacifiCare and Western Health Advantage. The plans have since said that they're improving their processes and encouraging physicians to boost their compliance with pay-for-performance programs. Physicians have long argued that it would also help to better reimburse them [1] for time spent on prevention (and lifestyle discussion, too).

To learn more about the report:
- read this piece [2] from the Los Angeles Times

Related Articles:
Focus on preventive care at CMS. Report [3]
The prevention dilemma: no profits. Report [1]
California officials plan PPO 'report card.' Report [4]