The National Committee for Quality Assurance ranked Capital District Physicians' Health Plan, Kaiser Foundation Health Plan of the Mid-Atlantic States and Tufts Benefit Administrators among its highest-performing commercial health plans for 2019-20.
NCQA rated 1,000-plus health insurance plans based on clinical quality, member satisfaction and NCQA Accreditation Survey results for its rankings. The organization said its rating system emphasizes care outcomes and what patients say about their care. Health plans' overall score is the weighted average of all measures.
Below are NCQA's top ratings, with the first five plans achieving the highest score of 5.0, and the remaining attaining the second-highest score of 4.5:
1. Capital District Physicians' Health Plan (New York; HMO) — 5.0
2. Capital District Physicians' Healthcare Network (New York; HMO/POS) — 5.0
3. Kaiser Foundation Health Plan of the Mid-Atlantic States (District of Columbia, Maryland, Virginia; HMO) — 5.0
4. Tufts Associated Health Maintenance Organization (Massachusetts, Rhode Island; HMO/POS/EPO) — 5.0
5. Tufts Benefit Administrators (Massachusetts; PPO) — 5.0
6. Anthem Blue Cross and Blue Shield of Connecticut (HMO/POS) — 4.5
7. AultCare Insurance Company (Ohio; HMO) — 4.5
8. Blue Care Network of MIchigan (HMO) — 4.5
9. Blue Cross and Blue Shield of Rhode Island (PPO) — 4.5
10. Blue Cross and Blue Shield of Massachusetts (HMO/POS) — 4.5
11. Blue Cross and Blue Shield of Massachusetts (PPO) — 4.5
12. Capital District Physicians' Healthcare Network (New York; PPO) — 4.5
13. Capital Health Plan (Florida; HMO) — 4.5
14. CDPHP Universal Benefits (New York; PPO) — 4.5
15. Dean Health Plan (Wisconsin; HMO) — 4.5
16. Fallon Community Health Plan (Massachusetts; HMO/POS) — 4.5
17. Group Health Cooperative of South Central Wisconsin (HMO) — 4.5
18. Group Health Plan (Minnesota; HMO/POS/PPO) — 4.5
19. Harvard Pilgrim Health Care (Maine, Massachusetts; HMO/POS) — 4.5
20. Harvard Pilgrim Health Care (Massachusetts; PPO) — 4.5
21. HealthNow New York (HMO/POS/PPO) — 4.5
22. HealthPartners Administrators (Iowa, Minnesota, Wisconsin; HMO/POS/PPO) — 4.5
23. HealthPartners (Minnesota; HMO/POS/PPO) — 4.5
24. Independent Health Association (New York; HMO/POS) — 4.5
25. Johns Hopkins US Family Health Plan (Maryland; HMO) — 4.5
26. Kaiser Foundation Health Plan-Southern California (HMO) — 4.5
27. Kaiser Foundation Health Plan of Colorado (HMO) — 4.5
28. Kaiser Foundation Health Plan-Hawaii (HMO) — 4.5
29. Kaiser Foundation Health Plan-Northern California (HMO) — 4.5
30. Martin's Point US Family Health Plan (Maine; HMO) — 4.5
31. Martin's Point US Family Health Plan (Massachusetts, New Hampshire, New York, Pennsylvania, Vermont; HMO) — 4.5
32. Network Health Plan (Wisconsin; HMO/POS) — 4.5
33. Sharp Health Plan (California; HMO) — 4.5
34. UnitedHealthcare Services (Rhode Island; PPO) — 4.5
35. UnitedHealthcare Insurance Company (Rhode Island; PPO) — 4.5
36. UPMC Benefit Management Services (Pennsylvania; HMO) — 4.5
37. UPMC Health Coverage (Pennsylvania; HMO) — 4.5
38. UPMC Health Plan (Pennsylvania; HMO) — 4.5
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