Were there ratings that weren't in the paper that you based the "poor" on? From what I saw, they were rated as "fair".  I was a member of BFMC for years and would go without insurance if I had to go back there. I have GemCare now and have never had a problem. In the case of my kids, I have been floored with how much they do and how little wait I had. Everyone I know who once had BFMC that now has GemCare all say the same thing, they wouldn't go back on a bet. I had Kaiser about 15 years ago and had a terrible experience but I have heard good things about them now. 

If your wife's doctor didn't do her job, why is that the medical groups fault?

I HATE BFMC!!!! My father went to the ER with a bad cough and chest pain. Before we even saw a doctor, some lady from BFMC came in, reeking like cigarrettes and perfume, told us he needed to be sent home with hospice and we should make him comfortable. We were of course shocked, we didn't know he was dying. The next day the hospice nurse comes out, starts talking to us and my father, she puts her stethescope on his chest, calls 911, says he has pneumonia in both lungs. He was admitted for 3 days, had some actual treatment and is perfectly fine today. That was about a year and a half ago. If that's what they call patient care, I have news for them. Too bad they didn't call me, they would have gotten an ear full. 

Steph

Anonymous,
   First of all, you're right. GEMCare was rated fair. I learned that after I posted the blog and I immediately corrected it.

    After changing several doctors who had issues with GEMCare, or vice versa, the physican assistant problem seemed part of the same poor service. You have a good point.

    I'm glad you have had a good experience with GEMCare. I personally have had no bad experiences but I go to the doctor once every two or three years so it's hard to screw up on me.

    I was surprised BFMC was rated so well. I have the same impression of Kaiser as you have -- used to be bad, but is now better.

  

I am a gemcare member and I could tell you the CEO or the higher ups in that organzation go to the doctors and there is no waiting for an authorization, its all approved. But members have to wait for a review and hope you don't get denied. They call it preventive care first before send you out to a specialist

 I have been in HMOs for many years both in LA and here and I had never had trouble until I came here.  Nothing has been horrific but there are delays, miscommunications, and then the attitude you get when you call them....
Steve said that Gemcare didnt received the proper paperwork for my referal. That is what they told me but when I called the doctors office to check on it they said they had sent it twice.  So Im not sure who dropped the ball here but the way I was treated by Gemcare was awful.
Way back a number of years ago I went to a routine physical and they wanted blood work. No big deal. The doctors office said they could no longer draw blood as Gemcare now has a contract with PAL.. Its not a huge problem but for someone who has a very demanding job its hard to get to two places (the doctors office and PAL) everytime you have an appt.  I called Gemcare and I asked if there was  a PAL draw station near my home as I had a meeting at work in 45 minutes so I wouldnt have time to go downtown. The woman said very nicely "let me find out I will call you right back".....I waited 10, 15, 20, 30 minutes...getting a little anxious but I can go another day.  This same lady calls me back as I am leaving to go to my meeting and says "my supervisor told me to tell you that if you had just gone downtown instead of calling us you would be done by now "...Ok now, Im mad..   And everytime I have had to call them I get this same kind of attitude.  Now after 10 years I have had to change my  primary doctor twice and had two specialists I cant see anymore. Right now Im sort of without a doctor because they cancelled my primary as of 9/20 but my new doctor whom I picked from a very short list of doctors who would take new Gemcare patients .... doesnt become my doctor until 10/1.....and Im in the middle of treatment....Im sure they would find a way to have me treated if I call them but I really dont want to talk them.

Scary Mary - my experience with customer service reps, healthcare or not, has been that they are all crappy when it  comes to customer service! My husband works in an industry where part of his business has several of them. He says they are all middle-aged women that are obese, drink gallons of diet soft drinks everyday, are on Prozac, and all of them seem to have a sob story of some sort.  Many come and go in that department, but they all are very much alike. So, I'm not sure customer service reps are a good judge of how good a company is. I had Blue Cross for several years and delt with many horrible customer service reps at the actuall insurance agency, but the coverage was good and I got to see good doctors.

My husband actually works for GemCare's managing company and in our experience it has been one of the best companies to work for and draw benefits from. They are prompt in their responses on claims/authorizations and they treat their employees well too.

Mucus, how do you know what Angelides wants to do? All of his commercials have Arnold in them. 
I'm still trying to figure out why he would put his movie star opponent in his commercials. Good luck with that Phil.

"Yeah, Angelides has the "solution", Payne in the Neck.......$30 billion in higher taxes.......that's $1000 for every man, woman and child in Californicate.........go ahead, vote for the Socialist Angle-iffish, Payne.........instead of buying health insurance with your $1000, it can go to the State for more bennies for illegals, shiftless bums, transients, losers, loiterers, malingerers, fraud merchants, and other assorted worthless garbage.......yep, that'll solve the problem.......", mucus mucus mucus, you sure know how to poil my party, you mean Imight have to pay?
You make so difficult, beside I am a republkan, does that disqualify me?

Mucus, what good would going to the doctor be?  You know what an incompetent lot *THEY* are.
.
Let's hear your rant on doctors.  Make sure it's heavy on the homo-erotic imagery so we'll know it's really you.

Don't feed the trolls.  Mocus1 is just a cover for some political hack or mindless drone.

I'm glad that HMO's and health care providers are getting rated on quality issues.  We should be seeing more of that in the future.  Standards based care and fair comparisons to your peers breeds healthy competition - one of the best aspects of a truly capitalistic society.

That some half assed pseudo-conservative thinks this is a Democrat position is almost funny.

GEMCare is not an HMO.  They are a medical group that contracts with HMOs.  People seem to think that GEMCare makes all of the decisions concerning their referrals and denials of service, when in reality they are set by the HMOs and all GEMCare does is act out what the HMOs dictate.  GEMCare doesn't have a choice in saying what is and what isn't approved, because the HMOs have already set that.  If you have a problem with your insurance not providing coverage for something you need, then switch HMOs.  If you have a problem with customer service with the Doctor you visit, then switch Doctors or possibly Medical Groups. 

I've been with Kaiser and BFMC and had pretty good care with both for the most part.  One major exception was when I needed surgery a few years ago I had to get authorization for the OBGYN to go ahead.  I had an incident that they thought might cause a stroke so it was delayed while they ran a bunch of tests.  By the time that was done and I went in to get my surgery date, the doc told me he had been let go by BMFC and that I would need to seek another doctor.  I was devastated since I had already waited a long time.  The next doc told me I didn't need surgery, just some other kind of care.  The next day or so someone from the med center called to ask about my experience and I went off on her.  I told her this latest doc had an assembly line going and that I was UNHAPPY  (to say the least).  She called back and told me they got me in with still another doc who took one look at me and ordered surgery.
All this started while I was on the job...probably 2 months of it..and then I was off work for 6 months.  I didn't blame BFMC specifically but I DID blame the HMO system which puts you at the mercy of a board of people who decide your medical care,  not your doctor.

Another time, my doctor ordered a colonoscopy but it was denied saying that it was not indicated and that I was okay 'd to have the lower intestine test instead.  (brain fade..can't think of what it's called.)

Now...considering my personal experience with the HMO system, and listening to what some Canadians have to say about their he lath care system, I feel we already have socialized health care in the form of HMO's.   The difference is..it's NOT free.

It ain't good, but it's better than nothing, and it's all I have.   

My favorite part out of today's article:

"You do scores, but the rating is really not based on the average of those scores," Mendoza said. He added, "It's a little misleading, but we try to make it easy for the user."

Dear anony, re Gemcare not being the HMO.  Correct me if Im wrong but here is the way I have it in my head. Just as an example, I have blue Shield as my carrier but Gemcare is one of the HMO's or "gatekeepers" for Blue Shield in this area.   The contracts between the providers (treating physicians) and Blue Shield are handled by Gemcare.  To witt, the 4 letters that I have received in the last 10 years advising me that I cannot continue with a certain doctor have all come to me on Gemcare letterhead. The denials I have had for tests and services have also come on Gemcare letterhead....It's my understanding that  these decisions are made by a medical utilization review provider at Gemcare.  I have called Blue Shield and they will discuss the covered benefits, co pays and exclusions but not the contracted providers or the medical utilization review denials. They send you back to Gemcare for that information. So how can you say that Gemcare doesnt make those decisions? 
To be a Health Care Organization (HMO) you dont have to be the insurance carrier, in some cases such as in Kaiser's case they are both. In many cases the insurer contracts with a PPO (preferred Provider Organization) or HMO to be the gatekeeper as with Gemcare.

Anyone that uses an HMO should be fully aware that if they are old or if they are terminally ill the standard practice for their provider is to defer until dead. I know I use to work for them (Kaiser)  but my self conviction was to strong.