Community-Based Health Plans Top National Ratings

For Immediate Release
September 18, 2015

CONTACT: Rachel Schwartz
rschwartz@achp.org
202-785-2247

Alliance of Community Health Plans (ACHP) member organizations lead the National Committee for Quality Assurance’s (NCQA) Health Insurance Plan Ratings 2015–2016, with 8 commercial plans earning a rating of 5, and 25 earning a rating of or 4 or 4.5; 7 Medicare plans earning a rating of 5 and 21 earning a rating of 4 or 4.5; and 1 Medicaid plan earning a rating of 5 and 7 earning a rating of 4 or 4.5. The 2015-2016 ratings are available on NCQA’s website. Approximately 600 plans are included in the commercial NCQA Health Insurance Plan Ratings but only 11 received the top rating of 5. Only 9 of the approximately 480 Medicare plans and one of the nearly 270 Medicaid plans received a top rating of 5.

“The NCQA rating provide consumers, employers and other purchasers with information they need to choose the best health plans. The high performance of ACHP plans is a direct reflection of our commitment to delivering affordable, high-quality coverage to our members and our communities,” said ACHP President and CEO Patricia Smith.

“The ratings show that our health plans are committed to providing excellent service and high-quality care to members. At CDPHP®, we are honored to receive such high marks from NCQA and strive to be an industry leader year after year,” said John D. Bennett, president and CEO of CDPHP®, which received a rating of 5 for its commercial HMO plan.

This year, NCQA moved to a rating system from a ranking system in part to harmonize quality improvement efforts with the Centers for Medicare and Medicaid’s star ratings system for Medicare Advantage organizations, which are published in October.

NCQA’s quality measurement program drives quality improvement that directly affects more than 170 million Americans nationwide. Health plans are rated based on clinical performance, member satisfaction and NCQA accreditation. NCQA publishes its Health Insurance Plan Ratings annually.

 

 

ACHP Plans Receiving a Rating of 5 on the 2015-16 NCQA Health Insurance Plan Ratings

Commercial/Private

  • Capital District Physicians’ Health Plan (HMO)
  • Capital District Physicians’ Healthcare Network (HMO/POS)
  • Kaiser Foundation Health Plan of Northern California (HMO)
  • Kaiser Foundation Health Plan of the Mid-Atlantic States (HMO)
  •  Tufts Associated Health Maintenance Organization (HMO/POS)
  • Tufts Benefit Administrators (PPO)
  • UPMC Benefit Management Services (HMO)
  • UPMC Health Coverage (HMO)

Medicare

  • Capital Health Plan (HMO)
  • Group Health Plan (Cost) (HealthPartners) (HMO)
  • Kaiser Foundation Health Plan of Georgia (HMO)
  • Kaiser Foundation Health Plan of Northern California (HMO)
  • Kaiser Foundation Health Plan of Southern California (HMO)
  • Kaiser Foundation Health Plan of the Mid-Atlantic States (HMO)
  • Kaiser Foundation Health Plan of the Northwest (HMO)

Medicaid

  • Kaiser Foundation Health Plan – Hawaii (HMO)

 

About ACHP
The Alliance of Community Health Plans (ACHP) is a national leadership organization bringing together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care. ACHP’s member health plans provide coverage and care for more than 18 million Americans. These 23 organizations focus on improving the health of the communities they serve and are on the leading edge of innovations in affordability and quality of care, including primary care redesign, payment reforms, accountable health care delivery and use of information technology. 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.