NCQA ratings: A look at the best, worst health plans this year


Though most health plans rated by the National Committee for Quality Assurance this year landed in the middle of the pack, those that performed highest shared several common traits.

The NCQA ranked 1,012 plans according to consumer satisfaction; the extent to which they provide preventive services; and how well they perform in treating chronic and acute conditions. In each category, patient outcomes count extra in the score, the organization said in an announcement emailed to FierceHealthPayer.

Here’s a look at some of the key findings:

  • Overall, 10 percent of plans received a 4.5 or 5 out of 5, while just 3 percent landed in the lowest tier, earning ratings of 1.5 to 2.
  • The top-rated plans were split relatively evenly between private, Medicare and Medicaid plans, the NCQA says.
  • The 10 states with the highest percentage of plans with a 4.5 or higher were Massachusetts, Rhode Island, Wisconsin, Maine, New Hampshire, Minnesota, Vermont, New York, Hawaii and Iowa.
  • As in years past, Kaiser Foundation health plans and the plans associated with integrated systems such as Tufts, Johns Hopkins and UMPC rated the best among private plans.
  • Maryland’s Jai Medical Systems Managed Care Organization earned top marks among Medicaid plans, while Group Health Plan Inc., of Minnesota and Wisconsin, ranked the highest in the Medicare category.
  • Among plans reporting complete data, WellCare Health Plans of New Jersey Inc. scored the lowest in the Medicare category; a United plan in Texas scored the lowest for Medicaid; and the Hawaii Medical Service Association scored the lowest among private plans.

While health plan leaders have sometimes questioned whether evaluation by the NCQA is necessary, generally they understand the need for quality measures to guide consumers’ choices, President Peggy O'Kane said in an interview earlier this year. The organization, which turned 25 in 2016, decided this year to publish its rankings on WebMD.

NCQA graphics