Your Plan’s NCQA 2014 Rating
How does your health plan’s quality rank? The National Committee for Quality Assurance put out its 2014-2015 NCQA annual list of the best health plans, based on clinical performance, member satisfaction and NCQA accreditation surveys. Topping the list are Massachusettes insurers – Tufts, Harvard Pilgrim Health and Blue Cross Blue Shield of Massachusettes. The NY Metro area winners were Upstate’s Independent Health Association, Capital Districts Physician Health Plan and MVP.
The NCQA believes its own health plan accreditation program and program data could useful to exchange programs, the NCQA says. With so much more individual choice on both, the Marketplace Health Exchange and off-Exchange along with new Health Insurers this is an important consumer tool.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA accredits and certifies a wide range of health care organizations and recognizes physicians in key clinical areas. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health care choices.
NCQA accreditation ratings are based on three sets of measurements HEDIS®, CAHPS® and NCQA accreditation standards. Health plans in every state, the District of Columbia and Puerto Rico are NCQA Accredited. These plans cover 109 million Americans or 70.5 percent of all Americans enrolled in health plans.
HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare health care quality. The Consumer Assessment of Healthcare Providers and System (CAHPS) is a survey mailed to select members asking them to rate their experience with the care given by their doctors and the services provided by their plans.
How the Results of HEDIS and CAHPS Help Consumers
Results from HEDIS and CAHPS enable consumers to understand how well Insurers are fulfilling our clinical agenda to help members stay healthy, get better quickly or live effectively with chronic illness. In addition, the scores facilitate our ability to identify areas of care and service where we can continue to improve. The results also enable us to compare our companies’ performance with other local and national health plans.
The “Excellent” ratings our plans received demonstrate that members continue to receive high-quality health care and that they are satisfied with the service that their physicians, health care practitioners and health plans provide.
HEDIS® (Healthcare Effectiveness Data and Information Set) is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® (Consumer Assessment of Healthcare Providers and Systems) is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
For more information about these plans and the full range of offerings available through MMS Inc. contact us today at (855) 667-4621.