Community-Based Health Plans Lead National Rankings

September 19, 2013

CONTACT: Rachel Schwartz
rschwartz@achp.org
202-251-8881 (cell)
202-785-2247 (office)

WASHINGTON, D.C. —This year’s National Committee for Quality Assurance (NCQA) rankings of health plans are once again topped by Alliance for Community Health Plans member organizations, with all 10 of the nation’s top ten Medicare plans, 5 of the top ten plans in the commercial rankings and 5 of the top ten plans in the Medicaid rankings offered by ACHP members. The 2013 rankings are available on NCQA’s website.

“American consumers are looking for the best health plans to meet their needs and keep them healthy. The NCQA rankings are an essential tool for consumers, employers and other purchasers looking for the best health care for their money. The high performance of ACHP members is a direct reflection of our commitment to delivering affordable, high quality coverage to our patients and our communities,” said ACHP President and CEO Patricia Smith.

NCQA’s measurement drives quality improvement that directly affects more than 118 million Americans nationwide. Health plans are ranked based on clinical performance, member satisfaction and NCQA accreditation. NCQA publishes its Health Insurance Plan Rankings annually.

“The continued high ranking of ACHP health plans reconfirms that health care is local and the most sustainable solutions to transforming health care will be achieved at the local level.  By consistently providing higher quality care and service to our members, ACHP patient-centered plans’ focus on effective and efficient care earns us deservedly high rankings year after year,” said ACHP Board Chairperson Michael W. Cropp, M.D., president and CEO of Independent Health in Buffalo, New York.

Visit ACHP.org for more information, including a table of ACHP member plans’ rankings, further analysis of the ratings and rankings, and member stories.

About ACHP
ACHP is a national leadership organization that brings together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care in their communities. The community-based and regional health plans and provider organizations from across the country that make up ACHP’s membership provide coverage and care for approximately 16 million Americans. These 22 organizations focus on improving the health of the communities they serve and are on the leading edge of patient care coordination, patient-centered medical homes, accountable health care delivery, use of information technology and other innovations leading to improvements in affordability and the quality of care. To learn more about ACHP, go to www.achp.org.

About NCQA
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA
accredits and certifies a wide range of health care organizations. It also recognizes clinicians
and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care.

 

Commercial Plans – Top 50

Rank     Plan

2             Kaiser Foundation Health Plan of the Northwest (HMO)
6             Tufts Associated Health Maintenance Organization (HMO)
7             Kaiser Foundation Health Plan of Northern California (HMO)
8             Tufts Benefit Administrators (PPO)
10           Kaiser Foundation Health Plan of Ohio (HMO)
11           UPMC Health Plan (HMO)
12           UPMC Benefit Management Services (HMO)
13           Kaiser Foundation Health Plan of Colorado (HMO)
15           Capital Health Plan (HMO)
16           Kaiser Foundation Health Plan of the Mid-Atlantic States (HMO)
17           Kaiser Foundation Health Plan of Southern California (HMO)
18           Capital District Physicians’ Healthcare Network (HMO)
19           Capital District Physicians’ Health Plan (HMO)
20           Kaiser Foundation Health Plan of Georgia (HMO)
21           Group Health Cooperative of South Central Wisconsin (HMO)
22           Geisinger Health Plan (HMO)
25           Kaiser Foundation Health Plan – Hawaii (HMO)
26           CDPHP Universal Benefits (PPO)
26           Capital District Physicians’ Healthcare Network (Self-Funded) (PPO)
30           HealthPartners (HMO/PPO)
31           Independent Health Association (HMO)
34           Fallon Community Health Plan (HMO)
41           Priority Health (HMO)
45           Security Health Plan of Wisconsin (HMO)
48           UPMC Health Network (PPO)
48           UPMC Benefit Management Services (PPO)

Medicare Plans – Top 20

Rank     Plan

1             Kaiser Foundation Health Plan of Southern California (HMO)
2             Kaiser Foundation Health Plan of Northern California (HMO)
3             Kaiser Foundation Health Plan of the Northwest (HMO)
4             Kaiser Foundation Health Plan of Colorado (HMO)
5             Kaiser Foundation Health Plan – Hawaii (HMO)
6             Capital Health Plan (HMO)
7             Geisinger Health Plan (HMO)
8             Kaiser Foundation Health Plan of the Mid-Atlantic States (HMO)
9             Capital District Physicians’ Health Plan (HMO)
10           Security Health Plan of Wisconsin (HMO)
11           Kaiser Foundation Health Plan of Ohio (HMO)
12           Group Health Cooperative (HMO)
12           Priority Health (HMO)
14           Group Health Plan (Cost) (HealthPartners) (HMO)
15           Fallon Community Health Plan (HMO)
16           Kaiser Foundation Health Plan of Georgia (HMO)


Medicaid Plans – Top 20

Rank     Plan
1             Fallon Community Health Plan (HMO)
2             Kaiser Foundation Health Plan – Hawaii (HMO)
3             Network Health (Tufts ) (HMO)
5             Priority Health (HMO)
9             Capital District Physicians’ Health Plan (HMO)
12           Security Health Plan of Wisconsin (HMO)
15           UPMC For You (HMO)
20           Independent Health Association (HMO)