ANNUAL HMO REPORT RELEASED STATE OFFICE RATES MEDICAL GROUPS.

Byline: Staff and wire services

SACRAMENTO - Half of the state's 18 million patients in health maintenance organizations can't leave their HMO because their employers only offer one insurance plan, but they may be able to find a better medical group within that HMO.

On Tuesday, Davis administration officials released the 2002 HMO Quality Report Card, designed to give consumers more information about HMOs and medical groups so they can find a doctor who will best serve them.

The report card rates 10 of the largest HMOs in California, representing approximately 95 percent of the state's HMO enrollees.

This year, the report focused on 80 of the state's largest medical groups in 11 regions, rating overall services, specialty care, patient relationships and timely care.

Kaiser Permanente was among the best-ranking HMOs in the San Fernando Valley. The Oakland-based company received three stars - the top rating - for care that enables patients to stay healthy. Conversely, the HMO received the poorest rating for care to those living with illness.

Dr. Joel Hyatt, an assistant medical director for Kaiser, said the report has evolved over the years, garnering more credibility. However, the consumer still has to look out for other reports.

``These studies are maturing year after year. For the most part, we're happy with our performance,'' Hyatt said. ``What has to be determined is whether you grade on the curve? What is the threshold?''

For Dr. Vincent Riccardi, president of the La Crescenta-based American Medical Consumers, the report card is a futile attempt to rank HMOs.

``Trying to reduce HMOs to a set of 10 boxes somehow diminishes the credibility of such a study,'' he said. ``Instead of helping people that are sick, the report card looks as though it helps those who are already healthy.''

Health Net, whose ranking was below average in most categories, has attempted to improve its less-than-stellar performance on previous report cards. Brad Keiffer, spokesman for the Woodland Hills-based company, said the data used in the most recent report card was already released more than a year ago.

``And this report card does not reflect the numerous improvements that we've made,'' Keiffer said.

Blue Cross of California performed slightly better than Health Net. Still, Michael Chee, a spokesman for the Thousand Oaks-based HMO, said there's ``nothing earth-shattering about this data that has been publicly reported for some time. That's not to say we don't take the data seriously, though.''

The report by the state's Office of the Patient Advocate found that patients tend to be happy with the relationships with their doctor, but are less satisfied with the medical groups' ability to offer timely care.

Martin Gallegos, director of the Office of the Patient Advocate, called the report an ``anxiety-relieving remedy.''

``When people are aware of their health care options, they are able to get the best care available,'' Gallegos said, adding that the report card makes it easier for HMO enrollees to compare different health care groups in their area.

It's based on a survey of more than 35,000 HMO patients in the state.

``This is not a movie rating,'' said Daniel Zingale, director of the Department of Managed Health Care. ``A missing star can mean a missing surgeon, or a missing service.''

The Office of the Patient Advocate was created in 2000 as part of Gov. Gray Davis' HMO reform plan.

The report card is available in English, Spanish and Chinese at the Patient Advocate's Web site, www.opa.ca.gov. A pamphlet summarizing the information will also be available at doctor's offices, pharmacies and libraries around the state.