Health plans and providers in the North Bay overall received high marks in a state survey from the state Office of the Patient Advocate.

Kaiser Permanente's San Rafael Medical Center earned four stars, the highest possible ranking on the "report card." In all of California, Kaiser was the only health plan to receive the four-star mark, with both its Southern and Northern California HMO plans earning the four-star rating.

For health plans and medical groups serving Sonoma County, the Meritage Medical Network earned three stars, as did Kaiser's Santa Rosa Medical Center and Sutter Medical Group of the Redwoods. Sonoma County Primary Care IPA earned only one star.

In Solano County, the following medical groups and HMOs received three stars: Hill Physicians Medical Group, John Muir Physician Network, Kaiser Permanente Medical Group -- Napa-Solano Service Area, Sutter Independent Physicians, Sutter Medical Group and Woodland Clinic Medical Group. NorthBay Health Group received two stars.

The "report card" ranked medical groups, HMOs and PPOs on six key categories: asthma treatment, cancer detection, chlamydia screening, diabetes and heart care and treatment of children.

Other major health plans that serve the North Bay include Blue Shield, Heath Net, Anthem Blue Cross and UnitedHealthcare, all of which received three stars.

The rankings will take on added importance for consumers as the state's online health benefits exchange, Covered California,  is implemented this coming October, with health plans effective Jan. 1, 2014, according to the Office of Patient Advocate.

Additionally, the Centers for Medicaid and Medicare Services will be taking into account patient satisfaction, among other new measures, in determining a given hospital's reimbursement rate for Medicare patients, prompting small and large health systems alike to take note of such ratings.