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NCQA Releases Health Insurance Plan Ratings for 2015

NCQA Releases Health Insurance Plan Ratings for 2015

National Committee for Quality Assurance (NCQA) has released new ratings, for measuring the performance of consumer health insurance plan in key areas.

The new methodology has been in development for over two years, and it provides a more accurate view on the state of various health insurance plan, by evaluating the quality of service rendered by over 1000 health insurance plans. NCQA’s Health Insurance Plan Ratings 2015–2016, covered about 138 million people. They analyzed 1.358 health insurance plans, and ranked 1,016; Medicaid – 149, private – 491 and Medicare – 376.

The new ranking for health insurance plan, gave priority to the satisfaction of the consumer and their health outcomes, and remains in harmony with the CMS Star Ratings of Medicare Advantage plans.

Key deductions from the 2015-2016 health insurance plan ratings:

Source: NCQA

  • Great Lakes and New England health insurance plans, are the best in customer satisfaction and performance. Wisconsin, Vermont, Maine, New Hampshire, Massachusetts, Michigan, Pennsylvania and New York health plans, received the highest percentage of 4.5 to 5.0 out of 5. * Out of 1,016 health insurance plans, 11% got the best ratings – 4.5 to 5.0 out of 5, while 5% received 1.0 to 2.0. Under a graph, most of the plans fall in the middle, thus forming a bell curve.
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NCQA earlier health insurance plan ranking, is in conjunction with Consumer reports and US News. NCQA ratings comprises of:

  • Consumer Satisfaction obtained from surveys
  • Prevention – the role each health insurance plan play in preventing diseases through regular tests
  • Treatment – how the health insurance plan, provide recommended scientific care, for most sickness like heart disease, depression & diabetes.

The outcome of a patient, brings an extra score during scoring for health insurance plan, in each category. In this case, is the disease brought under control or under specific recommended levels?

This emphasis on results means that, together with consumer satisfaction, outcomes are the main driver of ratings results – NCQA said.

The broad categories under which these health plans were grouped, provide consumers a simple guide to knowing their health insurance plan better. Drilling further, any consumer can learn how a particular health issue is being handled, under a health insurance plan.

For instance, the efficiency of postpartum and prenatal care, may be of interest to expectant couples, while some families may want to know more about the 10 procedures of pediatric preventive care and cure.

NCQA says it will maintain consumer Reports-NCQA relationship.

About NCQA

The National Committee for Quality Assurance, is a non-profit, private organization focused on improving the quality of medical care. They rate the health insurance plan, accredit health care organization, and recognizes key are of performance for clinicians.