Coming just ahead of the opening of health insurance exchanges, Harvard Pilgrim Health Care topped the list of the National Committee for Quality Assurance annual rankings of 2013 health plans, followed by Kaiser Foundation Health Plan of the Northwest.
Harvard Pilgrim, a repeat winner, had four plans in NCQA's top 10 list – the leading HMO serving Massachusetts and Maine and also other plans in Massachusetts and New Hampshire.
Four of the five top plans are in the Boston-New England region, making it the go-to location for quality health care. The No. 2 Kaiser plan serves Oregon and Washington.
Many insurers will offer enrollment in plans on state health insurance exchanges beginning Oct. 1. Open enrollment will be available through March 2014.
NCQA, a non-profit group that accredits healthcare organizations for improving quality, ranked 484 private health plans, 131 Medicaid HMOs, and 405 Medicare Advantage plans based on their clinical performance, member satisfaction and NCQA accreditation. To be eligible for ranking, health plans had to authorize public release of their performance information and submit data for analysis.
Health plans were ranked based on their combined Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS) and NCQA Accreditation scores. The rankings are also published in the November issue of Consumer Reports for wider consumer availability, NCQA said.
Michael Sherman, MD, chief medical officer of Harvard Pilgrim, said in a news release its ranking results from its ability to partner closely with its providers and "to innovate in ways that reward high value and improved health outcomes."
Added to the rankings was data about diabetes care factors and if a health plan was above the mean for quality or below the mean for hospital utilizations for that type of plan in that region serving similar members.
According to NCQA, the top 10 health insurance plans for 2013-2014 are:
1. Harvard Pilgrim Health Care - HMO (ME, MA)
2. Kaiser Foundation Health Plan of the Northwest – HMO (OR, WA)
3. Blue Cross and Blue Shield of Massachusetts HMO Blue – HMO (MA)
4. Harvard Pilgrim Health Care – PPO (MA)
5. Harvard Pilgrim Insurance – PPO (MA)
6. Tufts Associated HMO – HMO (MA)
7. Kaiser Foundation Health Plan of Northern California – HMO (CA)
8. Tufts Benefit Administrators – PPO (MA, RI)
9. Harvard Pilgrim Health Care of New England – HMO (NH)
10. Kaiser Foundation Health Plan of Ohio – HMO (OH)