NCQA Health Insurance Plan
NCQA’s Health Insurance Plan Ratings 2017–2018 lists private (commercial), 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, 2017.
NCQA will publish all ratings on its website in late September, to ensure that this valuable information reaches consumers across the nation.
Health Insurance Plan Ratings 2017–2018 use the same methodology as in 2016. Plan scores range from 0–5, in 0.5 increments, which is similar to the CMS Five-Star Quality Rating System.
Look back at last year’s ratings (2016).
Information for Health Plans
The 2017 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 announcement alerts plans that NCQA will rate plans in 2017.
Plan Data Confirmation—Late May
(Action Required) Confirmation of the HEDIS and CAHPS submissions and other information used (e.g., organization name, states, accreditation status) to calculate ratings. Plans have 5 business days to confirm.
HEDIS and CAHPS Submission—June 15
This submission deadline is defined in the HEDIS Volume 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: The plan did not submit data or opted not to report data publicly.
- Low Enrollment: The plan did not submit data or opted not to report data publicly, and its enrollment is fewer than 8,000 members.
Plans have 5 business days to confirm.
Final Ratings Notification—Early September
A private release of final ratings to all plans.
NCQA Releases Ratings—September 20
Final ratings posted on NCQA.org. Embargo on plan rating-related promotions ends at 6:00 p.m. ET; plans may begin advertising their ratings at this point.
Questions? Contact NCQA’s Health Insurance Plan Ratings Help Desk at my.ncqa.org.
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).