Washington, D.C. (October 5, 2023) – The Alliance of Community Health Plans (ACHP) member companies continue to lead the nation in key health measures, setting nonprofit, community-based health plans apart from other payers. The National Committee on Quality Assurance’s (NCQA) Health Plan Ratings for 2022-2023 show that across commercial, Medicare and Medicaid products, ACHP member companies continue to outperform the industry, scoring more than half a rating higher on average compared to non-ACHP health plans. The NCQA Health Plan Ratings reflect a weighted average of a plan’s HEDIS and CAHPS ratings plus the Accreditation status of a plan.
“ACHP member companies continue to excel in all the areas that matter most,” said ACHP President and CEO Ceci Connolly. “This national recognition highlights the strength of the nonprofit, payer-provider model in health care, as well as our members’ commitment and success amid exceptionally strong headwinds to continue driving innovation to cut costs and propel value.”
ACHP member companies make up 20 percent of plans scoring four stars and above, with Kaiser Foundation Health Plan (Mid-Atlantic States) and Independent Health being the only health plans in the nation to earn five stars for their commercial products.
Since 2018, ACHP members have maintained a strong quality edge, with ACHP plans having a higher average score than non-ACHP plans for 92 percent of measures. ACHP plans scored the highest on reporting member diversity, prenatal checkups and postpartum care.
Seven ACHP members offered commercial plans that received a rating of 4.5 stars, including Capital District Physicians’ Health Plan (CDPHP), Dean Health Plan, Group Health Cooperative of South-Central Wisconsin (GHC-SCW), HealthPartners, Kaiser Foundation Health Plan (Southern California and Northern California), Martin’s Point Health Plan and UPMC Health Plan.
Nearly one-third of Medicare plans rated four stars and above are offered by ACHP member companies, including AultCare, Capital District Physicians’ Health Plan (CDPHP), Dean Health Plan, Geisinger Health Plan, Health Alliance, HAP, Independent Health, Kaiser Foundation Health Plan (Georgia, Hawaii, Washington, Northwest), Martin’s Point Health Plan, Priority Health, Security Health Plan, UCare and UPMC Health Plan.
What’s more, ACHP members’ Medicare plans perform more than half a rating higher than non-ACHP plans, reflecting ACHP’s commitment to high quality coverage and care. ACHP plans scored the highest on reporting member diversity and two measures examining smooth transitions of care: receipt of discharge information and notification of inpatient admission.
ACHP member plans earned a higher average score than non-ACHP plans for 88 percent of all measures. ACHP members scored the highest on reporting member diversity, blood pressure control for patients with diabetes and prenatal immunizations.
Nine ACHP member plans achieved a rating of at least 4 stars, including Capital District Physicians’ Health Plan (CDPHP), Dean Health Plan, Fallon Health, Geisinger Health Plan, Health New England, Kaiser Foundation Health Plan (Mid-Atlantic, Hawaii), Security Health Plan, Select Health and UPMC Health Plan.
NCQA ratings are available on the NCQA website.
The Alliance of Community Health Plans (ACHP) represents the nation’s top-performing nonprofit health companies, which serve tens of millions of Americans across nearly 40 states and D.C. ACHP member plans collaborate with providers on high-quality coverage and care — leading the industry in practical reforms, including MA for Tomorrow, our vision for the future of Medicare Advantage.
ACHP is the voice of a unique payer-provider partnership model advancing proven solutions that deliver better value for patients, employers and taxpayers. Contact us for case studies and data about member innovations and results.