Ever wonder if you’ve chosen the best health plan for you and your family? How does your health plan stack up against others? With so many options, making a decision can be tough, but we have a tool to make that choice easier: NCQA’s 2018 Health Insurance Plan Ratings.
These ratings tell us how health insurance plans are performing in the most important areas of health care: consumer satisfaction, prevention and treatment.
Our Health Insurance Plan Ratings give consumers with a practical and meaningful guide to understanding their health care options and choosing the best health plans for themselves and their families. This year, NCQA rated over 1,000 private, Medicare and Medicaid health plans.
Yes, we have a Top Ten List!
Top Ten States with the Highest-Rated Health Plans (receiving a 4.5 or 5.0 out of 5 rating) for Three-Year Average:
- Rhode Island
- New Hampshire
- New York
Key Takeaways from the 2018–2019 Ratings:
- States with the Top-Performing Plans Consistently Deliver: Over the last three years, there’s been very little movement within the top ten states except for Iowa and Hawaii, that in 2015 were 12th and 11th respectively and moved into the top ten in 2016 and 2017.
- High and Low Performers Are Rare: Of the 1,040 rated plans, 85 (8%) received a top rating of 4.5 or 5.0 out of 5. Twenty-five (2%) earned the ratings of 1.0 to 2.0.
Ratings Focus on Satisfaction & Outcomes
The ratings consist of three major performance categories: consumer satisfaction, prevention and treatment.
- Consumer Satisfaction: What patients say about their health plans in satisfaction surveys, including about claims processing and customer service.
- Prevention: Checkups, tests and other care that keeps people—especially children—healthy.
- Treatment: How consistently a plan provides scientifically recommended care for common, costly conditions such as diabetes, depression and heart disease.
In each category, the results—outcomes—of a patient’s care count extra in the scoring; for example, whether blood pressure and diabetics’ blood sugar are controlled to safe, recommended levels.
This emphasis on results means that, together with consumer satisfaction, outcomes are the main driver of ratings results.
- Simple, User-Friendly Scale: The NCQA ratings blend dozens of quality indicators for health plans into a simple scale from 1–5, where 1 indicates lower performance and
5 indicates higher performance.
By grouping plans into a few broad categories, the ratings give consumers a practical, meaningful guide to understanding their health care choices at a level of detail they choose.
- Details on Demand: Consumers can “drill down” into any part of the ratings to learn how a health plan handles particular health issues or patient populations.
For example, expectant parents may be interested in performance on two measures
of prenatal and postpartum care. Families may be interested in quality results on
10 measures of pediatric preventive care and treatment, ranging from well-child care for infants, to monitoring ADHD treatment of 12-year-olds.
NCQA’s Health Insurance Plan Ratings are available on NCQA’s website: https://bit.ly/2NXqrrf.
For information on how the ratings were calculated, visit NCQA ratings methodology: https://bit.ly/2xyxc9F.