SOURCE: National Committee for Quality Assurance (NCQA)

National Committee for Quality Assurance (NCQA)

October 03, 2016 16:58 ET

NCQA Releases 2016 Health Insurance Plan Ratings

More Than 1,000 Health Plans Are Rated Based on Performance and Quality of Care

WASHINGTON, DC--(Marketwired - October 03, 2016) - National Committee for Quality Assurance (NCQA) announces its 2016 Health Insurance Plan Ratings. These ratings provide consumers with a more accurate picture of how health insurance plans perform in the key quality areas of consumer satisfaction, prevention and treatment.

NCQA's Health Insurance Plan Ratings 2016-2017 compare the quality and services of more than 1,000 health plans in the United States.

Under a new agreement, NCQA and WebMD are teaming up to publish the ratings. WebMD will begin publishing the ratings on its flagship consumer website, WebMD.com.

WebMD is the leading provider of health information services and tools, serving consumers, physicians, healthcare professionals, employers and health plans. The WebMD website has 74 million unique monthly US visitors according to comScore.

"WebMD is the ideal organization to distribute the NCQA Health Insurance Plan Ratings," said Margaret E. O'Kane, President of NCQA. "Now, more people who are engaged and interested in their health care will have access to these ratings, enabling them to make more informed decisions about which health plans are best suited for their needs. This is an important step in making health plan information more accessible to wider audiences."

"WebMD is committed to providing tools and resources that address consumers' need for greater transparency related to costs and quality when choosing health care options," said Steve Zatz, M.D., Chief Executive Officer, WebMD. "NCQAs Health Insurance Plan Ratings support our mission of empowering health decision-making for WebMD's large and engaged audience of consumers."

About the Ratings:

NCQA studied 1,401 health plans and rated 1,012: 503 private (commercial), 338 Medicare and 171 Medicaid.

The ratings are a system similar to CMS Star Ratings of Medicare Advantage plans, and give unprecedented importance to health outcomes and consumer satisfaction.

Key Takeaways from the 2016-2017 Ratings Include:

  • New England and Great Lakes Plans Perform Best: States with the highest percentage of plans receiving a 4.5 or 5.0 out of 5 rating include Massachusetts, Rhode Island, Wisconsin, Maine, New Hampshire, Minnesota, Vermont and New York. Hawaii and Iowa round up the top ten.
  • High and Low Performers Are Rare: Of the 1,012 rated plans, 105 (10%) received a top rating of 4.5 or 5.0 out of 5. Twenty-seven (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 plotted on a graph. http://bit.ly/2cHgZV2
  • Commonalities among plans: The percent of top-rated plans are relatively the same between Private (Commercial), Medicare and Medicaid plans.

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 care, customer service and physicians.
  • Prevention: How well plans provide screenings, immunizations and other preventive services.
  • Treatment: How well a plan performs in treating chronic and acute 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.

NCQA's Health Insurance Plan Ratings are available on Sept. 22 by visiting http://doctor.webmd.com/find-health-insurance. For information on how the ratings were calculated, visit NCQA ratings methodology: http://bit.ly/2cr94OT

About NCQA
NCQA is a private, nonprofit 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. NCQA's Web site (ncqa.org) contains information to help consumers, employers and others make more informed health care choices.

About WebMD
WebMD Health Corp. is the leading provider of health information services, serving consumers, physicians, healthcare professionals, employers, and health plans through our public and private online portals, mobile platforms and health-focused publications. The WebMD Health Network includes WebMD.com, Medscape.com, MedicineNet.com, eMedicineHealth.com, RxList.com, Medscape Education (Medscape.org) and other WebMD owned sites and apps.

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