Kaiser Permanente and Mid Atlantic Medical Services Inc. ranked highest in an annual report of managed-care insurers published yesterday by the Maryland Health Care Commission.

The report acts as a guide for consumers hoping to make sense of the region's vast array of insurers. For 12 years, the commission has produced the "report card," which offers rankings on such matters as breast cancer screening, diabetes care and the quality and efficiency of behavioral health care. The scores are determined from a combination of questionnaires filled out by the companies and from health plan records. A separate group of scores measures how much care was given and the processes the insurers use to send reminders to members about checkups.

"That information is directed for a small employer who doesn't have the human resources dollars to go out and request this," said Joyce Burton, the commission's chief of health plan quality and performance. "It looks at the programs to see how they are engaging consumers."

This year, the commission included preferred provider organizations, or PPO plans, which are less restrictive than HMOs and have grown popular nationwide. This year's guide offers a side-by-side comparison of HMO and PPO plans.

Of the seven HMOs and four PPO plans that participated in the report, Kaiser and MAMSI scored highest. The others with above average scores included: Cigna and CareFirst BlueChoice of the HMO plans, and Aetna PPO.

Information and to view the report: www.mhcc.maryland.gov.