What are the nation’s best, worst health plans?
Blue Cross and Blue Shield of Massachusetts HMO Blue, Johns Hopkins U.S. Family Health Plan and Tufts Associated Health Maintenance Organization are among the top-rated health plans in the United states, according to National Committee for Quality Assurance’s 2016 Health Insurance Plan Ratings.
The six lowest ranked health plans, alphabetized by name: Cigna Health and Life Insurance, New Mexico; Connecticut General Life Insurance, New Mexico; Hawaii Medical Service Association; Humana Health Plans of Puerto Rico; Rocky Mountain Hospital and Medical Services (Anthem), Nevada; and UnitedHealthcare of Oklahoma. These plans received between a 2.0 and 1.5 rating, with 1.0 being the lowest possible.
The top private (commercial) health plans with a top 5.0 rating are Blue Cross and Blue Shield of Massachusetts HMO Blue Inc.; Capital District Physicians' Health Plan Inc. (Albany NY); Capital District Physicians' Healthcare Network Inc. (CDPHN); Capital Health Plan Inc. (Tallahassee, Fla.); Johns Hopkins U.S. Family Health Plan -- HMO; Kaiser Foundation Health Plan of the Mid-Atlantic States Inc.; Kaiser Foundation Health Plan Inc. - Northern California; Martin's Point U.S. Family Health Plan (ME); Tufts Associated Health Maintenance Organization Inc; Tufts Benefit Administrators Inc.; UPMC Benefit Management Services Inc.; UPMC Health Coverage Inc.; and UPMC Health Plan Inc.
The best states
If you are looking for a top-rated health plan, it helps to live in Massachusetts, Rhode Island or Wisconsin. This was one of the findings of the National Committee for Quality Assurance’s 2016 Health Insurance Plan Ratings.
Rounding out the top 10 health plans by state are Maine, New Hampshire, Minnesota, Vermont and New York, Hawaii and Iowa. According to the ranking, the health plans of the south and west do not appear on the NCQA’s Health Insurance Plan Ratings 2016–2017’s Top 10 List.
Health plans in New England and the Great Lakes region performed the best with the highest percentage of plans receiving a 4.5 or 5.0 out of 5 rating
The NCQA metrics
NCQA’s Health Insurance Plan Ratings 2016–2017 compare the quality and services of 1,401 health plans and rated 1,012: 503 private (commercial), 338 Medicare and 171 Medicaid. The ratings consist of three performance categories: consumer satisfaction, prevention and treatment.
Also in the ratings, the number of high and low-performing health plans are not a common occurrence. Of the 1,012 plans that were rated, 10% earned a top rating of 4.5 or 5.0 out of 5 and only 3% earned the ratings of 1.5 to 2.0.
“Most plans are in the middle, approximating a “bell curve” when all plans’ performances” are taken into account, according to NCQA.
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NCQA also found that top-rated plans share many similarities between Private (Commercial), Medicare and Medicaid plans.
Under a new agreement, NCQA and WebMD are teaming up to publish the ratings.