NCQA Releases 2025 Health Plan Ratings

September 17, 2025 · Becky Kolinski

NCQA’s 2025 Health Plan Ratings are here! Ratings offer valuable insights into how well plans perform on key health measures and how satisfied members are with their care. By making this information publicly available, NCQA aims to empower consumers, employers and policymakers to make informed health care decisions and to encourage health plans to improve performance and prioritize member needs.

This year, almost a thousand commercial, Medicare Advantage (MA) and Medicaid health plans earned a 1–5 star rating from NCQA.

How Do Ratings Work?

Health plans are rated on a scale of 0–5 stars. NCQA considers plans with 4.5 and 5 stars as the highest-rated health plans in the nation. Ratings are based on three types of quality measures:

• Measures of clinical quality from the Healthcare Effectiveness Data and Information Set (HEDIS^®) and the Health Outcomes Survey (HOS).
• Measures of patient experience using the Consumer Assessment of Healthcare Providers and Systems (CAHPS^®).
• Results from NCQA’s review of a health plan’s structure and quality processes (Health Plan Accreditation).

The overall rating is the weighted average of a plan’s HEDIS, CAHPS and HOS measure ratings, plus Accreditation bonus points, if the plan is Accredited by NCQA. The 2025 Health Plan Ratings are primarily based on 2024 performance data, with some MA metrics reflecting 2023 results due to reporting schedules.

Learn more about the Ratings methodology here.

What’s New for 2025?

NCQA added a new HEDIS measure in the 2025 ratings: Language Diversity of Membership (LDM). This measure evaluates whether health plans actively identify and collect data on members’ preferred spoken and written languages, and has an initial scoring weight of 0.5.

You can view all the changes to the 2025 measure list here.

Highlights and Results

This year, 11 plans earned a 5-star rating—more than double the number of 5-star plans from last year—and 55 plans achieved a 4.5-star rating. NCQA observed positive trends in quality measures.

Stronger Transitions of Care in Medicare

• Meaningful year-over-year improvement in transitions of care for Medicare beneficiaries, which demonstrates better coordination and continuity across care settings.

Progress in Chronic Condition Management

• Increases in five of six diabetes-related measures across commercial and MA, and increases in all six measures for Medicaid.
• The most significant improvement was seen in Kidney Health Evaluation for Patients With Diabetes (KED), which experienced an average increase of more than 5% across all three product lines.

Stabilization of Immunization Measures

• An upward trend in adult and adolescent immunization rates, with improvement observed in several measures.
• Stabilization of childhood immunization rates in Medicaid plans, which are declining at a reduced pace compared to last year.

How Can You Use Ratings?

Ratings serve as a national benchmark for health care quality and outcomes, which can support broader quality improvement efforts.

Policymakers and Regulators

• States use NCQA Health Plan Ratings to evaluate and select health plans that provide high-quality care for Medicaid beneficiaries.
• Many states mandate NCQA Accreditation for Medicaid health plans, which requires plans to submit data for scoring in the ratings.
• Ratings can play a strategic role in helping states meet Medicaid and CHIP Quality Rating System goals and stay aligned with CMS Final Rule requirements.
• State and federal programs, including Medicare, use ratings performance data for value-based payment programs to reward plans that deliver superior care.
• Ratings are publicly available on NCQA’s Health Plan Report Card website for industry benchmarking and transparency, allowing states to compare plans and hold them accountable for performance.

Health Plans

• Ratings help plans identify gaps in care and services and can serve as a roadmap for targeted quality improvement strategies.
• Ratings incentivize continuous improvement by highlighting areas of excellence and underperformance.

Consumers and Employers

• Ratings help employers and consumers identify health plans that consistently deliver high-quality care and prioritize member experience.
• Consumers and employers can search for a health plan by name, filter health plans based on criteria (e.g., star rating, location) and compare results across multiple plans for health topics such as diabetes or maternal health.

View the 2025 Health Plan Ratings here.

Fun Fact: In 1995, NCQA released results of its Report Card pilot project, which used audited HEDIS data to assess performance of 21 health plans across 36 performance measures. For the first time, consumers and employers had access to standardized information to help them choose a health plan. The pilot project evolved into NCQA’s Health Plan Ratings.

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).