NCQA Health Insurance Plan
View NCQA's 2016-2017 Health Insurance Plan Ratings
NCQA’s Health Insurance Plan Ratings 2016–2017 lists private, Medicare, and Medicaid health insurance plans based on their combined HEDIS®, CAHPS® and NCQA Accreditation standards scores.
The NCQA Accreditation status used in these ratings are as of June 30, 2016.
NCQA will publish all ratings on its Web site in late September ensuring that this valuable information reaches consumers across the nation.
Health Insurance Plan Ratings 2016–2017 uses the same Ratings methodology from 2015, which classifies plans into scores from 0-5 in 0.5 increments–-a system similar to CMS’ Five-Star Quality Rating System.
Look back at last year's ratings (2015)
Information for Health Plans
The 2016 Schedule for NCQA’s Health Insurance Plan Ratings:
Ratings Project Announcement - March
Message sent to: HEDIS and Accreditation staff, medical director, CEO, marketing manager
This notification alerts plans that NCQA will rate plans in 2016.
Plan Data Confirmation - Late May
(Action Required) Confirmation of the HEDIS and CAHPS submissions and other information used (e.g., display name, states, Accreditation status) to calculate ratings. Plans have 5 business days to confirm.
HEDIS and CAHPS Submission - June 15
This submission deadline is as defined in the HEDIS Vol. 2 Technical Specifications.
Projected Ratings Notification – Early August
(Action Required) Confirmation of Accreditation status and overall rating or 1 of 3 reasons a rating cannot be calculated:
- Partial Data Reported – The plan submitted HEDIS data but not CAHPS data (or vice versa); or the plan earned an NCQA Accreditation status that does not require HEDIS.
- No Data Reported – Plan did not submit data or opted not to report data publicly.
- Low Enrollment – Plan did not submit data or opted not to report data publicly, and the organization's enrollment is less than 8,000 members.
Plans have 5 business days to confirm.
Final Ratings Notification - Early September
A private release of the final ratings to all health plans.
NCQA Releases Ratings - September 20
Final Ratings Posted on NCQA.org - Embargo on plan rating-related promotions ends 6:00 p.m. ET; plans may begin advertising their ratings at this point.
Contact NCQA’s Health Insurance Plan Ratings Help Desk at my.ncqa.org if you have questions.
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).