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CALOPTIMA RATED TOP MEDI-CAL PLAN IN CALIFORNIA
National Committee for Quality Assurance (NCQA) recognizes CalOptima’s overall quality
ORANGE, Calif. (September 20, 2016) — CalOptima is California’s top-rated Medi-Cal plan, according to the NCQA’s Medicaid Health Insurance Plan Ratings 2016–2017. It is the third year in a row that NCQA has named CalOptima best overall in the state.
CalOptima received a score of 4 out of 5 — the highest score awarded to any Medi-Cal plan in California. Further, only 15 Medicaid plans of the 171 reviewed nationwide scored higher. The NCQA ratings are based on standardized, plan-reported data regarding health care quality and customer satisfaction.
“Our NCQA rating shows that CalOptima’s commitment to quality is steadfast,” said Michael Schrader, Chief Executive Officer. “Being California’s top plan for the third year means our members can rely on CalOptima and thousands of Orange County doctors and hospitals to consistently deliver quality care.”
NCQA assesses Medicaid plan quality based on 43 clinical measures related to both preventive care and treatments. Preventive measures report whether members get services to keep them healthy, such as well-child visits, immunizations and nutrition counseling. Treatment measures gauge whether members receive appropriate care in response to illnesses and chronic diseases, including diabetes and high blood pressure. NCQA also evaluates a plan based on nine customer satisfaction dimensions, such as getting care quickly and how well doctors communicate.
A county organized health system, CalOptima provides publicly funded health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, Calif. CalOptima’s mission is to provide members with access to quality health care services delivered in a cost-effective and compassionate manner. In total, CalOptima serves nearly 800,000 members with a network of more than 7,200 primary care doctors and specialists, as well as 30 hospitals.
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS is the most widely used performance measurement tool in health care. NCQA’s website (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.
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