Kaiser Permanente was rated California's top health care plan on report cards issued Wednesday by a state agency that has been assessing health plans and providers for more than a decade.

Kaiser's Northern and Southern California HMOs received "excellent" ratings, the highest of four scores, for quality of care and for patient satisfaction in the Health Care Quality Report Cards issued by the state Office of the Patient Advocate.

The eight other major HMO plans -- including Blue Shield, Health Net, Anthem Blue Cross and UnitedHealthcare -- were rated "good," the second-highest score, on quality of care.

The scores were based on the percentage of patients who received care at levels matching national standards.

Rating medical groups that serve Sonoma County, the report card gave an "excellent" grade to Kaiser's San Rafael Medical Center and a "good" score to Kaiser's Santa Rosa Medical Center, the Meritage Medical Network and Sutter Medical Group of the Redwoods.

Sonoma County Primary Care IPA received a "poor" rating, meaning half or fewer of its members received standard care.

Each medical group also was rated on six categories of care: asthma, checking for cancer, chlamydia screening, diabetes and heart care and treatment of children.

Two local physicians said the state report cards are important to patients and providers.

"The way we treat patients is becoming more apparent to them," said Dr. Gary McLeod, a family practice physician who is medical director of quality for Sutter Medical Group of the Redwoods. The group includes 361 primary care physicians and specialists.

That transparency encourages health care providers "to become more competitive," he said, and to practice more preventive medicine.

Judy Coffey, Kaiser's senior vice president and Marin-Sonoma area manager, said the organization was "proud to be recognized for the care and service we provide our members and patients."

Kaiser's Santa Rosa Medical Center serves 145,500 members, and the Kaiser system holds about 40 percent of the local market.

Dr. Kirk Pappas, Kaiser's physician-in-chief, said the organization looks at the Patient Advocate's ratings and other assessments every year.

"You always want to do better," he said. "We know that service is how people are going to select us."

Pappas questioned the grade given to Kaiser for ease of getting care, which the state agency rated as "fair."

"Where else can you get an appointment on Saturday or Sunday?" he said. "Our market share speaks for itself."

All the HMOs were rated fair or poor by their members for ease of getting care, while the overall patient experience ratings were, for all but one HMO, good or excellent.

State Insurance Commissioner Dave Jones said the report cards "provide consumers with essential information to make informed choices."

About 1.2 million Californians will be shopping for health coverage under the Affordable Care Act starting next year, and another 1.8 million will qualify for Medi-Cal coverage.

But David Hodges, a Santa Rosa health insurance broker, said the report cards failed to show much difference among the HMOs and medical groups in Sonoma County.

"I don't see anything here that would drive anyone toward anything or away from anything," he said.

Kaiser deserves its top ratings, he said, for providing "absolutely the best preventative care" and "great access for members."

The health insurance marketplace is competitive, Hodges said, with more than 90 percent of companies with more than 100 employees offering at least two insurance companies, each with two plans.

Four of the county's seven hospitals were rated on the state report cards for eight types of service, including heart bypass surgery and maternity and treatment of heart failure, hip fracture and pneumonia.

Palm Drive, Petaluma Valley and Sonoma Valley hospitals did not participate in the ratings.

The report cards are available at the Patient Advocate's website, www.opa.ca.gov and on a new mobile app available from iTunes.

You can reach Staff Writer Guy Kovner at 521-5457 or guy.kovner@pressdemocrat.com.