NCQA is pleased to collaborate with U.S. News & World Report to develop rankings of America’s Best Health Plans to help raise public awareness about health plan quality.

This year’s feature story is expected to be included in the November 17, 2008 issue of U.S. News & World Report (appearing on newsstands November 10). Once again it will include U.S. News/NCQA rankings of the nation’s top 50 commercial health plans, as well as the top 25 Medicare and Medicaid plans.  

Organizations will be informed of their rankings on Tuesday, November 4; the rankings will appear on the U.S. News Web site on Friday, November 7.

Please direct any inquiries about the rankings to NCQA Communications Manager Lauren Funk.

UPDATES

• Clarification of HOS scoring for Medicare plans. The Health Outcomes Survey (HOS) survey is fielded to a cohort of plan members each year; two years later, a follow-up survey is administered to the surviving members.  Five measures from this survey are scored for the rankings.  
  
  Plans that did not submit and were not required by CMS to submit HOS data in the cohort year(s) being used are given “NA” designations for the applicable HOS measures. Plans that did not submit and were required by CMS to submit HOS data will be given “NR” designations for these measures.  Note that two of the HOS measures rely on a baseline and a remeasurement year and are scored based on the change between the two. Accordingly, plans that fielded the HOS survey only in the remeasurement year will receive "NA" designations for the two applicable measures. (Updated October 9)

• Clarification of CAHPS scoring for Medicare plans. As noted below, NCQA is using CAHPS results from 2007 for scoring in Medicare plans. However, some plans were not required by CMS to submit CAHPS data in 2007; those plans will be recieve “NA” designations for all CAHPS measures. 
  
  Plans required by CMS to submit CAHPS data in 2007 that did not submit such data will receive “NR” designations. (Updated October 9)
  
  

• Timeline Adjustment U.S. News recently moved its publication schedule to a biweekly format; all the above dates have been adjusted accordingly. The new dates, which are displayed above, are one week later than previously published timelines. (updated August 26)
  
  
• HbA1c <7% measure not included in ranking methodology. Owing to preliminary data from a number of recent studies of the effects of stringent HbA1c management, NCQA will not publicly report the HbA1c <7% measures in 2008. This measure had been slated for public reporting for the first time this year; the measure will be considered for public reporting in calendar year 2009. Accordingly, the measure will be removed from the plan ranking methodology for America’s Best Health Plans; the remaining measures in the Prevention category will be rebalanced accordingly. (updated August 8)
  
  
• CAHPS data for Medicare plans. NCQA will not receive Medicare CAHPS data in time to include 2008 CAHPS data in the rankings this year. However, NCQA believes measures of patient satisfaction to be integral to any comprehensive assessment of quality. Accordingly, we have made the decision to use 2007 CAHPS data for Medicare plans in this year’s rankings.
  
  Note that select measures of prevention and treatment, such as Flu Shots in Adults and Medical Assistance with Smoking Cessation, are collected via CAHPS. The data will be weighted in a manner consistent with the 2008 methodology.
  
  NCQA is currently assessing the best way incorporate Medicare CAHPS data each year. We continue to review our options with an aim towards enabling a consistency in year-over-year rankings.
  
  

• Measures Removed to Avoid Widespread Imputation. Every year, NCQA removes any measure reported by fewer than half of all reporting plans in any given product line to avoid widespread imputation of values. This year, the measures to be removed are as follows:

   

  Commercial

  Medical Assistance with Smoking Cessation - Advising Smokers to Quit

  Medical Assistance with Smoking Cessation - Medications for Quitting

  Medical Assistance with Smoking Cessation - Strategies for Quitting

   

  Medicaid

  Medication for Rheumatoid Arthritis

  Antidepressant Medication Management - Contacts

  Antidepressant Medication Management - Acute Phase

  Antidepressant Medication Management - Continuation Phase

  7-Day Follow-up after Mental Illness

  Alcohol/Drug Dependence Treatment - Initiation of Treatment

  Alcohol/Drug Dependence Treatment - Engagement of Treatment

  Follow-up Care for Children w/ADHD Medication - Initiation

  Follow-up Care for Children w/ADHD Medication - Continuation and Maintenance

  Persistence of Beta-Blocker Treatment After a Heart Attack

  Use of Spirometry in the Assessment and Diagnosis of COPD
  
  No further measures were removed for Medicare plans. All the above changes are reflected in the updated methodology document.