NCQA has released an article which lists the rankings for private, Medicare, and Medicaid health insurance plans. Is your plan listed? The list includes 984 plans classified as either HMOs (health maintenance organizations) or PPOs (prefered provider organizations).
According to an article in Consumer Reports, http://www.consumerreports.org/content/dam/cro/magazine-articles/2012/November/Consumer_Reports_Health_Insurance_Rankings_November_2012.pdf, NCQA has ranked health insurance plans based upon the following factors:
- Overall score – scale is 1-100 with 100 as the top score
- Consumer satisfaction – scale is 1-5 with 5 as the top score
- Prevention measures – scale is 1 to 5 with 5 as the top score
- Treatment measures – scale is 1 to 5 with 5 as the top score
- Accreditation – accredited plans rank higher
- National rank – lower scores are desirable
NCQA is one of the top healthcare accreditation organizations in the nation. NCQA accreditation means the organization/plan has gone through a rigorous process of achieving national recognition for adhering to standards of excellence for quality and patient safety. Beginning in 2014, according to the Affordable Care Act, any plan sold through exchanges must be accredited. NCQA consultants are available through BHM Healthcare Solutions as well as other healthcare management consulting firms. These consultants can assist with the accreditation process. Policies and procedures are already in place so you don’t have to reinvent the wheel.
We invite you to comment on this article. Is your healthcare plan listed? Is this list important to you? Are there plans listed that surprise you in terms of where they are ranked? Is it important to you that your health plan is accredited? Are there other factors that you feel should be considered with these rankings? What do you think of the health insurance exchanges? Is the country heading in the right direction?
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