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I’m shopping for a new insurance policy. Are there any trustworthy resources out there that rate the quality of various health plans?

  • By
  • healthinsurance.org Contributor
  • November 13, 2013

Q. I’m shopping for a new insurance policy. Are there any trustworthy resources out there that rate the quality of various health plans?

A. Yes, the National Committee for Quality Assurance (NCQA) is a highly respected non-profit organization dedicated to improving health care quality. It accredits, compares and ranks health care plans by looking at:

  • Consumer satisfaction – what patients report about their experiences with doctors and services they had access to, as well as  customer service;
  • Prevention – the proportion of eligible members who received preventive services, such as prenatal and postpartum care, cancer screenings, and immunizations. It also looks at access to primary-and preventive-care visits for children and adolescents; and
  • Treatment – the proportion of eligible members who received the recommended care for conditions such as diabetes, heart disease, high blood pressure, osteoporosis, alcohol and drug dependence, and mental illness.

You will find NCQA’s 2013-2014 rankings, comparing 484 private commercial plans and 405 Medicare plans here.

Consumer Reports (CR), which boasts an excellent reputation for honest reporting, publishes the NCQA’s rankings each year and offers extremely useful commentary that explains what the ratings mean. (You will have to subscribe.)

Not all plans offered in the exchanges are rated by the NCQA. Some are new, and don’t yet have a track record. In addition, many of the plans that the NCQA rates are employer-sponsored plans. Insurers may sell very similar plans in the exchanges, but under different names.

Nevertheless NCQA ratings of large brands can help you narrow your choices. For instance, you will discover that non-profit carriers draw the highest ratings:

  • Kaiser Foundation plans in the Northwest, Northern California, Ohio, Colorado the Mid-Atlantic States, Southern California, and Georgia stand out on NCQA’s list of the top 20 health care plans nationwide.
  • Harvard Pilgrim in Massachusetts, Maine and New England takes first place. (Note, in 2015, Harvard Pilgrim will be offering insurance in the New Hampshire Exchange, where currently, only one carrier is offering.)

By and large, for-profit health plans do not fare as well in the NCQA rankings.

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