A new web tool from the California Department of Managed Health Care gives Californians a new way to research and compare health insurers.
The tool, which links to a state database that contains detailed health data on 25 million California residents and 123 health insurance plans, enables users to rank and compare health insurance plans on a variety of metrics including by market and type of enrollment, financial and premium reports, audits, consumer complaints and enforcement actions.
The goal of the new web tool, which consumers can access through a digital dashboard, is designed to give California residents more ways to go online to compare healthcare carriers.
The dashboard increases transparency and access to health plan data, says California Department of Managed Health Care director Shelley Rouillard. This online tool will make it easier for the public to find information on health plans in California, and will also help the department make better use of our data internally.
Some California healthcare watchdog and consumer advocacy groups already have already used the dashboard to unearth surprising results. For example, California Health Line, a research and reporting arm of the California Healthcare Foundation found that nearly two-thirds of Anthem Blue Cross enrollees who filed an appeal with the California Department of Managed Health Care to challenge a denial-of-care decision ended up getting the medical services they requested.
The was also the case with over half of the appeals filed by consumers with Blue Shield of California coverage and 45% of cases involving members of Kaiser Permanente, the states largest insurer. In some of those cases, the insurer itself decided to reverse its decision, writes California Health Line, in a blog post.
California Healthcare Foundation researchers used the dashboard to find that this year Anthem Blue Cross has been fined nearly $2 million by the California Department of Managed Care for violations, while another big insurerKaiser Permanentehas been fined by the state about $500,000. Users can see how health plan rates have changed over time, and which rate changes the department has deemed unreasonable, writes the California Health Care Foundation.
The California Department of Managed Health Care built the dashboard mostly internally using a $400,000 federal grant. Some outside help was provided by SimSoft Inc., a database development company. It took about a year to build the database and dashboard that consolidates the data from 12 disparate databases, Rouillard says.
It can be well worth the effort to go up against your health plan if it denies you treatment you think you need, writes the California Health Care Foundation. Thats just one of the many lessons consumers can glean by using a new online tool.”