Harvard Pilgrim Health Care (HMO/POS) tops the list of America's best health plans named by the National Committee for Quality Assurance (NCQA) for the eighth year in a row.
In descending order, the remaining top 10 NCQA-ranked health plans this year are:
• Tufts Associated Health Maintenance Organization (HMO/POS)
• Capital Health Plan (HMO)
• Tufts Health Plan (PPO)
• Harvard Pilgrim Health Care of New England (HMO/PPO)
• Kaiser Foundation Health Plan of Colorado (HMO)
• Group Health Cooperative of South Central Wisconsin (HMO)
• Geisinger Health Plan (HMO/POS)
• Harvard Pilgrim Health Care (PPO)
• Health New England (HMO/POS)
Harvard Pilgrim executives have said that healthcare IT has played a large role in the group's success in delivering quality.
"Harvard Pilgrim continues to top the nation's best health plan rankings because we make healthcare work better," said Eric Schultz, president and chief executive officer of Harvard Pilgrim. "We do it by continuously delivering superior customer service to our members while addressing healthcare affordability and the total cost of care – it's the heart and soul of our company and is true to our mission of better health for the communities we serve."
Harvard Pilgrim has a high-touch customer service model that includes proactively contacting members to explain their health benefits and to provide them with the information they need to make the best health care decisions. Harvard Pilgrim was founded by physicians more than 40 years ago and continues to have physicians, nurses and other clinicians actively involved in leading the non-profit health plan.
"Harvard Pilgrim has a broad network of doctors and hospitals available to our members across the three states we serve," said Michael Sherman, MD, MBA, senior vice president and chief medical officer of
Harvard Pilgrim. "We thank our provider partners for the superb care they deliver to our members, and recognize that supporting the patient/physician relationship is one of our most important responsibilities. By working collaboratively with these extraordinary healthcare providers to develop innovative, new care delivery models, together we bring greater value to our members."
NCQA is a private, non-profit organization dedicated to improving healthcare quality. NCQA officials said they did not create the field of healthcare performance measurement, but they have refined the process and led the development of objective measures since the mid-1990s when NCQA's standardized measurement tool, the Healthcare Effectiveness Data and Information Set (HEDIS), was broadly adopted by the industry.
HEDIS includes performance measures related to dozens of important healthcare issues. Selected measures include healthcare screenings and measures that help control or prevent chronic diseases.
The full list of this year's top 20 health plans can be found here.
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