Cost & Quality Atlas

California Regional Health Care Cost & Quality Atlas

CHCF Blog: IHA’s Jeff Rideout, M.D., uses Atlas data to explore the question of Do California HMOs 'Cost' More Than PPOs? It Depends on Who's Paying

Benchmarking and tracking regional performance on key quality and cost measures is critical to achieving high-quality, affordable, patient-centered care for all Californians. The California Regional Health Care Cost & Quality Atlas tracks performance on six clinical quality measures for the priority health conditions of cancer, diabetes, and asthma; hospital utilization; and average annual total cost of care per enrollee across 19 California geographic regions. 

A collaboration of IHA, the California Health Care Foundation (CHCF), and the California Health and Human Services  Agency, the online Atlas includes information about care provided in 2013 to 24 million Californians, nearly two-thirds of the state's total population, and spans commercial insurance products (HMOs and PPOs), Medicare Advantage, traditional Medicare fee for service (FFS), Medi-Cal managed care, and Medi-Cal FFS.

An analysis of Atlas data highlights wide geographic and prod­uct type variation in the quality and cost of care provided to commercially insured people across the state, indicating significant opportunities to improve both the quality and cost of care. With continued CHCF support, IHA in 2017 will update the Atlas with 2015 data, highlighting changes from the 2013 baseline data. For additional information, access the Cost Atlas News Release, Issue BriefFact Sheet, and slide deck.

HEDIS by Geography Hot Spotting

A pre-cursor to the California Regional Health Care Cost & Quality Atlas, IHA’s online tool—HEDIS by Geography—allows users to view health plan HEDIS (Healthcare Effectiveness Data and Information Set) results by geographic area to gain a clearer picture of population health across California. Users can examine performance on six clinical quality measures and three resource use measures, by health plan product line for about 19 million Californians, including commercial HMOs and PPOs, Medicare Advantage, and managed Medi-Cal. The project was funded by the California Health Care Foundation. 

Analysis of HEDIS by Geography data reveals two main themes: health plan products that rely primarily on integrated care delivery networks, such as HMOs and Medicare Advantage, generally have higher quality scores than other products without using more resources; and resource use and health care quality vary widely throughout the state.  For additional information access the HEDIS by Geography News Release, Issue Brief,  Fact Sheet, and slide deck.