September 15, 2022
WASHINGTON, DC—September 15, 2022—The National Committee for Quality Assurance (NCQA) today announced its 2022 Health Plan Ratings. The annual list evaluates commercial, Medicare and Medicaid health plans based on the quality of patient care, how happy patients are with their care and health plans’ efforts to keep improving.
The 2022 Health Plan Ratings are based on data from calendar year 2021, when 203 million people were enrolled in health plans that reported Healthcare Effectiveness Data and Information Set (HEDIS®) results to NCQA. Plans are rated on a 0–5 stars scale. Six out of 1,048 health plans that earned a numerical rating achieved 5 stars—the highest possible rating.
“With open enrollment for health plans beginning in November, the NCQA 2022 Health Plan Ratings provide timely insight to help consumers and businesses make informed decisions about their health care,” said NCQA President Margaret E. O’Kane. “NCQA was founded as an independent nonprofit in 1990 to ‘turn on the lights’ by measuring and holding health plans accountable for health care quality. With the 2022 ratings, we’re proud to spotlight top performers and identify ways to improve health care quality, access and equity.”
Key findings from the 2022 Health Plan Ratings include:
- 5-Star Rated Plans. Six plans achieved the highest overall rating:
- Commercial: Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
- Medicaid: Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.
- Medicare: Kaiser Foundation Health Plan of Colorado; Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.; Medical Associates Clinic Health Plan of Wisconsin dba Medical Associates Health Plans; and Medical Associates Health Plan, Inc.
- Better Care for Heart Disease. Several measures of cardiovascular care quality improved from the prior year. The most significant improvement was in controlling high blood pressure: After a decline from 2019–2020, average commercial plan performance improved 6.9 percentage points, Medicare plans improved 7.6 points and Medicaid plans improved 2.7 points.
- Rebound in Diabetes Care. Following a drop the year before, care for people with diabetes improved in two areas:
- Controlling blood pressure: Average commercial plan performance improved 5.5 percentage points, Medicare plans improved 2.5 points and Medicaid plans improved 2.1 points.
- Controlling Hemoglobin A1c: Average commercial plan performance improved 4.1 percentage points, Medicare plans improved 3.2 points and Medicaid plans improved 3.3 points.
- Divergence in Childhood Immunizations. Immunization rates rose 2.2 percentage points for children enrolled in commercial plans, but declined 3 points for children in Medicaid plans. This >5-point divergence suggests a growing gap in preventive care that puts America’s most vulnerable children at disproportionate risk for disease.
- Decline in Adults’ Satisfaction With Care. Adult patients’ overall ratings of their health care dropped for both commercial (4.2 percentage points) and Medicaid health plans (2.2 points) from the prior year.
Methodology
Each year, NCQA rates health plans that choose to publicly report HEDIS results . NCQA ratings are based on almost 50 assessments of patient care outcomes and experience, including measures of clinical quality from NCQA’s HEDIS and CMS’s Health Outcomes Survey; 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).
Please visit the NCQA website for details on the 2022 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 @ncqa and on LinkedIn at linkedin.com/company/ncqa.
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Media Contact
Theresa Masnik
SHIFT Communications
NCQA@shiftcomm.com
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).