Getting Doctors and Care Easily
2024-25 Edition
Why is it important to get specialist care, tests and treatments when needed?
Getting the right care at the right time means seeing a specialist doctor or getting tests when needed. Highly rated HMOs and PPOs make sure you do not face delays or hassles in seeing a specialist doctor or getting tests and treatment.
What can health plans do to help you get specialty care, tests and treatment easily?
Highly rated plans have systems in place that help you see a specialist or get a test or treatment when you need it. HMOs in California have time requirements for making appointments for their patients whether it is for specialty care, tests, or treatment.
What do the stars mean?
The scores show the percentage of health plan members who highly rated their HMO or PPO on getting the specialty care, tests, and treatment they needed, when they needed it. A higher score means more members said they were getting the right care at the right time.
The scores are based on information from a survey of a sample of at least 100 health plan members in 2023.
Data Disclaimer
The data source for data for the Report Cards is Quality Compass® 2024 and is used with the permission of the National Committee for Quality Assurance (NCQA). Quality Compass® 2024 includes Healthcare Effectiveness Data and Information Set (HEDIS®) and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data. Any data display, analysis, interpretation, or conclusion based on these data is solely that of the authors. NCQA specifically disclaims responsibility for any such display, analysis, interpretation, or conclusion. Quality Compass and HEDIS are registered trademarks of NCQA. CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
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