NCQA Unveils 2024 Health Plan Ratings

WASHINGTON, September 17, 2024 (Newswire.com) - The National Committee for Quality Assurance (NCQA) today announced its 2024 Health Plan Ratings, an annual list that evaluates commercial, Medicare and Medicaid health plans based on assessments of patient experience and clinical quality. The 2024 Health Plan Ratings are based on data from calendar year 2023, when approximately 227 million people were enrolled in health plans that reported Healthcare Effectiveness Data and Information Set (HEDIS^®) results to NCQA. 

Health plans are rated on a scale of 1–5 stars. NCQA considers plans with 4.5 and 5 stars as the highest-rated health plans in the nation. This year’s Ratings showed a slight increase in 5-star plans, with 5 out of 1,019 rated plans achieving the highest rating. Three were commercial and two were Medicare plans. There was also a slight increase in Medicaid and Medicare plans that achieved 4- and 4.5-star ratings, compared to 2023, demonstrating improvement across several health quality measures. 

“Annual Health Plan Ratings are vital to providing health care consumers with transparent and objective information about the quality and performance of health plans. Ratings not only help individuals make informed choices to receive the best possible care but also motivate health plans to improve their operations, with a focus on quality, equity and accountability,” said NCQA President Margaret E. O’Kane. 

NCQA continues to prioritize health equity in its Ratings methodology, reinforcing its commitment to promoting equity across the industry. This year, NCQA increased the scoring threshold for the Race/Ethnicity Diversity of Membership (RDM) measure and increased the measure weight from 0.5 to 1.0. Collecting race and ethnicity data is crucial for closing gaps in quality of care and promoting health equity. By encouraging broader stratification and collection of race and ethnicity data by health plans, Ratings can drive continuous quality improvement across the health care industry, ensuring that all patients receive the best possible care.

Methodology

Each year, NCQA rates health plans that choose to publicly report their HEDIS data. Ratings are based on nearly 50 assessments of patient care outcomes and experience, including measures of clinical quality from NCQA’s HEDIS and CMS’s Health Outcomes Survey (HOS); measures of patient experience using the Consumer Assessment of Healthcare Providers and Systems (CAHPS^®); and NCQA’s review of health plan quality improvement processes (NCQA Accreditation). 

The overall Rating is the weighted average of a plan’s HEDIS, CAHPS and HOS measure ratings, plus Accreditation bonus points, calculated on a 1–5 scale (5 is highest), displayed as stars and rounded to the nearest half-point.

Visit the NCQA website for details on the 2024 Health Plan Ratings, measures and methodology.

About NCQA

NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA Accredits and Certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS^®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make informed health care choices. NCQA can also be found at Twitter/X @ncqa and on LinkedIn at linkedin.com/company/ncqa.

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Source: National Committee for Quality Assurance (NCQA)