Covered California has unveiled health plan quality ratings to help guide insurance shoppers, ahead of most other states and the federal government.
The new system rates health plans on a four-star scale based on member satisfaction and experience surveys. Four stars indicates an insurer is ranking in the top quartile of all the rated plans, three stars are those in the 50 to 75 percent segment, two stars those in the 25 to 50 percent segment and one star those in the bottom quartile.
Public insurance exchanges aren't required to have health plan rating systems in place until 2016, and the federal government hasn't issued specific guidance yet. But at least Covered California and New York State of Health have decided to go ahead and offer health plan ratings to try to offer consumers an e-commerce-esque experience.
"We want to give consumers all the available tools to help them assess and choose plans in their regions," said Covered California executive director Peter Lee in a media release.
Data for the quality scores is from the HHS Agency for Healthcare Research and Quality's Consumer Assessment of Healthcare Providers and Systems, which surveys health plan members on their experience accessing doctors, tests and treatments.
Lee said Covered California is planning to expand the rating system once the federal standards are established with information on hospitals, physicians and clinical performance based on claims data and surveys of new exchange members.
"These scores are just the beginning of a robust reporting and evaluation system planned for 2016," Lee said.
Some of the new plans, like the Chinese Community Health Plan available in the Bay Area, won't have quality scores until 2015, after members are surveyed.
Among the 11 insurers selling in Covered California's 19 regional markets, none were ranked with one star, but four were ranked with only two stars: Health Net, Contra Costa Health Plan, L.A. Care Health Plan, and Molina Healthcare.
The only plans garnering fours stars are Kaiser Permanente, Western Health Advantage and Sharp Health Plan, while the rest, including Anthem and Blue Cross plans, garnered three stars.
Covered California has met its baseline health plan enrollment goal of 500,000 -- with 500,108 Californians enrolled in plans as of Jan. 21 -- and is heading toward the goal of 1.6 million by 2017.
Financial sustainability is a related issue to watch this year, since the exchange, per its charter, cannot receive state general funds; it's banking on premium fees in the long-run and federal-funding in the short-term. Including a recent $155 million federal "supplemental" grant awarded for marketing, enrollment assistance and technology, Covered California has received more than $1 billion in federal funding.