ACHP Statement in Reaction to NCQA Announcement of Top-10 Medicare and Medicaid Health Plans

Seven of NCQA’s top ten Medicare plans are ACHP members 

NCQA announcement underscores need for all Medicare plans to make the same quality information available to beneficiaries

WASHINGTON, D.C. Jack Ebeler, president and CEO of the Alliance of Community Health Plans (ACHP), issued the following statement today in reaction to the National Committee for Quality Assurance’s (NCQA) announcement of top Medicare and Medicaid health plans based on HEDIS® effectiveness of care clinical measures of quality:

“ACHP members talk a lot about the importance of quality.  Today’s NCQA announcement confirms that they are amongAmerica’s highest-performing Medicare and Medicaid health plans.

“NCQA is able to rank Medicare plans, because the Centers for Medicare & Medicaid Services (CMS) requires participating health maintenance organizations (HMOs) and local preferred provider organizations (PPOs) to make quality information available to the public.  This promotes quality care, helps consumers make informed choices and improves plan accountability.

“Unfortunately, CMS may soon allow new regional PPOs in Medicare to report significantly less quality information than HMOs and local PPOs already share with the public.  Therefore, some plans may not have to tell the public how well they manage patients with conditions like diabetes and high blood pressure – even though other plans would.

“Without apples-to-apples comparisons about the quality of all types of health plans, beneficiaries cannot make sound decisions.

“In the commercial market, many plans like to talk about the quality of the care they provide but don’t always make quality information available to beneficiaries.  CMS can make quality in Medicare a priority by ensuring that all types of participating plans share the same measures of quality with the public.”

Reporters’/Editors’ Note: 

Seven ACHP members – Capital Health Plan (Tallahassee, FL); Excellus
(Rochester, NY); Fallon Community Health Plan (Worcester, MA); HealthPartners (Minneapolis, MN); and Kaiser Foundation Health Plans (Colorado, Mid-Atlantic and Hawaii)
– were among NCQA’s top ten Medicare plans based on their performance on the HEDIS® effectiveness of care measures.

Three ACHP members – Excellus (Rochester, NY); Kaiser Foundation Health Plan of Hawaii; and UPMC Health Plan (Pittsburgh, PA) – were among NCQA’s top ten Medicaid plans based on their performance on the HEDIS® effectiveness of care measures.

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The Alliance of Community Health Plans brings together innovative health plans and provider organizations that are among America’s best at delivering affordable, high-quality coverage and care to their communities.  Drawing on years of experience, members collaborate to identify problems, share information and work toward solutions to some of health care’s biggest challenges.  Their work is the foundation for ACHP’s advocacy on behalf of better health care nationally.  More information is available at


Capital Health Plan; CareOregon; Excellus; Fallon Community Health Plan; Group Health Cooperative; Group Health Cooperative of South Central Wisconsin; Health Alliance Plan; HealthPartners; HIP; Kaiser Foundation Health Plans and the Permanente Federation; M•Plan; UCare Minnesota; UPMC Health Plan