The National Committee for Quality Assurance (NCQA) released its 2024 health insurance plan ratings and found that of the 1,019 plans evaluated, only five received the highest rating of five stars.
The annual list evaluates private, Medicare and Medicaid health insurance plans based on patient experience and clinical quality ratings. The 2024 health insurance plan ratings are based on data from the 2023 calendar year, when approximately 227 million people were enrolled in health insurance plans that reported Healthcare Effectiveness Data and Information Set (HEDIS) results to NCQA.
Of the plans that received five stars, three were private plans and two were Medicare plans: two Kaiser Permanente plans, a private plan available in the mid-Atlantic states (Baltimore, suburban Maryland, Northern Virginia, and Washington, D.C.), and a Medicare plan in Colorado.
Kaiser Permanente noted that for nine consecutive ratings cycles, it has more combined five-star and 4.5-star plans than any other health care organization.
“NCQA’s recognition further validates our dedication to providing high-quality care to our members in all of our markets,” Andrew Vindman, M.D., executive vice president and chief medical officer at Kaiser Permanente, said in a statement. “Our integrated model is designed to ensure we provide high-value care to our members.”
Other five-star winners were Blue Cross Blue Shield of Massachusetts’ Commercial PPO plan, New York-based Independent Health Association Inc.’s Commercial HMO/POS combined plan and Wisconsin-based Network Health Insurance Corp.’s Medicare PPO.
There was also a slight increase in Medicaid and Medicare plans earning four- and 4.5-star ratings compared to 2023, with improvements across several health quality indicators.
“Annual health plan ratings are essential to providing health care consumers with transparent and objective information about health plans’ quality and performance. The ratings not only help individuals make informed choices and receive the best care possible, but they also motivate health plans to improve their operations with an emphasis on quality, equity and accountability,” NCQA President Margaret E. O’Kane said in a statement.
NCQA continues to prioritize health equity in its assessment methodology. This year, NCQA increased the scoring threshold for its Racial/Ethnic Diversity Membership (RDM) measure, increasing the measure’s weighting from 0.5 to 1.0. The organization states that collecting racial and ethnic data is essential to closing gaps in health care quality and promoting health equity. By encouraging more extensive stratification and collection of racial and ethnic data by health plans, the assessment can foster continuous quality improvement across the health care industry to ensure all patients receive the best possible care.
Here are more details about the evaluation methodology: Each year, NCQA evaluates health plans that choose to release HEDIS data. The evaluation is based on approximately 50 assessments of patient care outcomes and experiences, including measures of clinical quality from NCQA’s HEDIS and CMS’ Health Outcomes Survey (HOS), measures of patient experience using Consumer Assessment of Healthcare Providers and Systems (CAHPS®), and NCQA’s review of health plan quality improvement processes (NCQA-certified).
The overall rating is a weighted average of a plan’s HEDIS, CAHPS, and HOS measurement ratings and certification bonus points calculated on a scale of 1 to 5 (5 being highest), expressed as stars and rounded to the nearest 0.5 point.
