September 29, 2021
ACHP’s nonprofit, community health plans were only payers in nation to earn top commercial rating
Washington, D.C. – The Alliance of Community Health Plans’ (ACHP) nonprofit, community-based member companies continue to outperform hundreds of other payers on key national health measures. According to the National Committee for Quality Assurance’s (NCQA) Health Insurance Plan Rankings for 2020-2021, ACHP members’ commercial, Medicare and Medicaid plans are highest rated in the country and maintained a competitive edge, scoring more than half a rating higher on average compared to other health plans.
“ACHP plans’ consecutively high marks affirm our members’ commitment and success working towards quality, affordability and healthier communities — in spite of challenges faced amid a global pandemic,” said ACHP President and CEO Ceci Connolly. “As demonstrated by this national recognition, our top-performing plans’ continuous innovation and focus on prevention drive down costs while creating value for American families.”
ACHP member companies Capital District Physicians’ Health Plan (CDPHP), Kaiser Foundation Health Plan (Mid-Atlantic States), UPMC Health Plan and Tufts Health Plan were the only health plans in the nation to earn five out of five stars for their commercial products.
ACHP health plans perform better than non-ACHP health plans on three composite measures: prevention, treatment and customer satisfaction. ACHP members also receive the highest ratings on numerous measures, including eye exams, prenatal checkups, women’s reproductive health, postpartum care and colorectal cancer screening.
UPMC Health Plan President and CEO Diane Holder, whose UPMC commercial plan earned a top rating, said, “By recognizing three of our commercial HMO plans with its highest five-star ratings, the NCQA confirms what our members know: UPMC Health Plan can’t be beat when it comes to access to high-quality, affordable care. From our outstanding clinical leadership to our award-winning Member Services team, we work hard to deliver the best care and service possible, as indicated by these top NCQA ratings.”
12 ACHP member companies offered commercial plans that also received a high rating of 4.5, including Dean Health Plan, Fallon Health, Geisinger Health Plan, Group Health Cooperative of South Central Wisconsin (GHC-SCW), Harvard Pilgrim Health Care, HealthPartners, Independent Health, Kaiser Foundation Health Plan (Southern California, Colorado, Hawaii and Northern California), Martin’s Point Health Care, Priority Health, Sanford Health Plan and Security Health Plan.
ACHP members’ Medicare plans perform exceptionally well — more than a full rating greater — compared to non-ACHP plans on several transitions of care measures: receipt of discharge information, notification of inpatient admission and patient engagement after inpatient discharge.
Additionally, nearly half of the 25 Medicare products that scored a 4.5 star rating or above are offered by ACHP member companies, including Capital District Physicians’ Health Plan (CDPHP), Kaiser Foundation Health Plan, Geisinger Health Plan, Security Health Plan and UCare.
ACHP members’ Medicaid plans achieved significantly higher ratings than other payers on the composite measures of prevention and treatment and earned at least a full rating greater compared to non-ACHP plans on measures including blood pressure control (140/90), appropriate testing and care and childhood immunizations status.
ACHP member Kaiser Foundation Health Plan (Mid-Atlantic States) was one of two total companies that scored a five star rating for their Medicaid plan. Additionally, Capital District Physicians’ Health Plan (CDPHP), Fallon Health, HealthPartners, Kaiser Foundation Health Plan (Hawaii) and Tufts Health Plan received a 4.5 rating for their Medicaid plans.
NCQA ratings are available on the NCQA website.
The Alliance of Community Health Plans (ACHP) represents the nation’s top-performing non-profit health plans to improve affordability and outcomes in the health care system. ACHP member companies serve more than 23 million Americans in 36 states and the District of Columbia. Members are provider-aligned health organizations that provide high-quality coverage and care to tens of millions of Americans. They are leading the industry in practical, proven reforms around primary care delivery, value-based payment and data-driven systems improvement. Learn more at the ACHP website and follow us on Twitter for the latest health insights.