OAKLAND Calif. — Michelle Melvin was at breakfast with her family one Sunday morning when she began feeling “a little funny.” Pain in her jaw and temples. Numbness in her forearms.
“I’m not supposed to have a heart attack,” said Michelle, who was 41 at the time. “But I was starting to get scared because I knew something wasn’t right.”
Despite her anxiety, Michelle knew exactly what to do next. A Kaiser Permanente member in Colorado for many years, she was aware she could seek guidance from Kaiser Permanente’s 24-hour advice hotline. After Michelle explained the combination of sensations she was experiencing, the nurse on duty advised her to go to a hospital immediately: Michelle was describing symptoms of a heart attack.
After her husband rushed her to their local hospital, Kaiser Permanente doctors monitored Michelle closely, performing a battery of tests. When her tests came back, they proved the nurse right — Michelle had sustained a heart attack. After the prompt medical attention, she fully recovered thanks to medication, exercise and routine follow-up care.
This type of high-quality, personalized and accessible care exemplifies Kaiser Permanente. It is so prevalent that once again Kaiser Permanente health plans are classified among the best in the nation for consumer experience, prevention and treatment, according to the National Committee for Quality Assurance report — NCQA’s Health Insurance Plan Ratings 2016-17 — that was published today.
NCQA’s annual report rates more than 1,000 health plans, including Medicare, Medicaid and Private (Commercial), on a 0-to-5 scale, with 5 being the best. Only 23 health plans in the country were given a 5 out 5 this year, and Kaiser Permanente has eight of them, more than any other organization. All Kaiser Permanente health plans were rated 4.0 or higher.
In addition, all Kaiser Permanente health plans are again rated highest (or tied for the highest) in both Medicare and Commercial in the areas they serve. Kaiser Permanente serves more than 10.6 million members in eight states and the District of Columbia.
Kaiser Permanente health plans are again among the highest rated health plans in the nation, according to NCQA’s Health Insurance Plan Ratings 2016-17.
- Kaiser Permanente Medicare health plans in Southern California, Northern California, Georgia, Hawaii and the Northwest are rated 5 out of 5. Only eight Medicare plans (out of nearly 350) received the highest rating.
- Kaiser Permanente Commercial (Private) health plans in Northern California and Mid-Atlantic States are rated 5 out of 5. Only 13 Commercial plans (out of more than 500) received the highest rating.
- Kaiser Permanente Hawaii’s Medicaid plan is one of only two Medicaid plans in the nation to be rated 5 out of 5. More than 150 Medicaid plans in the country were rated.
“Being recognized as the top-rated health plan in each of our areas is an exceptional acknowledgment that reflects our drive to provide affordable, high-quality health care coverage to our members and give our patients the outcomes they expect and deserve,” said Patrick Courneya, MD, executive vice president and chief medical officer for Kaiser Foundation Health Plan and Kaiser Foundation Hospitals. “Kaiser Permanente’s excellence is rooted in our clinical experience and evidence-based medicine approach, and we know our focus on prevention, early intervention and accessibility makes a difference in the lives of our members.”
Michelle’s follow-up care, which continues today, made a significant impact, she said.
“My cardiac rehab nurse was wonderful,” she said. “That was what I really appreciated. That one-on-one attention.”
“The Permanente Medical Groups select only the best doctors,” said Michael Kanter, MD, executive vice president and chief Quality officer, The Permanente Federation, the national organization for the nearly 19,000 physicians who exclusively provide care to Kaiser Permanente’s members. “We are supported by outstanding care teams, technology, data and systems designed to help us deliver the highest quality care with the patient at the center of everything we do.”
The NCQA’s Health Insurance Plan Ratings are based on combined scores for health plans in the Healthcare Effectiveness Data and Information Set®, commonly called HEDIS; the Consumer Assessment of Healthcare Providers and Systems®, or CAHPS; and NCQA Accreditation standards scores.
This is the 12th year NCQA has ranked or rated the nation’s health plans. From 2005-14, NCQA ranked the plans numerically from highest to lowest. Last year, for the first time, NCQA implemented a “ratings” system which classifies plans into scores from 0-5 in 0.5 increments. It is a method similar to the 5-Star Quality Rating System used by Centers for Medicare and Medicaid Services.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 10.6 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.