NCQA Releases 2026 Health Plan Ratings

NCQA’s 2026 Health Plan Ratings are available now. 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 healthcare decisions and to recognize health plans that continually strive to improve performance and prioritize member needs.

This year, almost a thousand commercial, Medicare Advantage (MA) and Medicaid health plans earned a 0–5 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 metrics:

• 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 NCQA-Accredited.

The 2026 Health Plan Ratings are based on Measurement Year (MY) 2025 data and percentiles for HEDIS and for commercial and Medicaid CAHPS. We use MY 2024 data and percentiles for Medicare CAHPS and HOS. Learn more about the Ratings methodology here.

What Is New for 2026 Ratings?

We added two measures, revised three measures to use the Electronic Clinical Data Systems (ECDS) reporting method and removed 12 measures from the 2026 Health Plan Ratings Measure List, located here.

Highlights and Results

This year, 18 plans earned a 5-star rating—an increase of 64% from last year—and 53 plans achieved a 4.5-star rating. NCQA observed positive trends in quality measures.

Behavioral Health Leads Performance Gains

Behavioral Health emerged as one of the highest-performing domains across product lines, reflecting increased investment in mental health access, care coordination and follow-up care. Follow-Up After Hospitalization for Mental Illness (FUH) was among the most improved measures, increasing by 8.9 percentage points in commercial, 9.0 points in Medicaid and 11.9 points in MA.

Chronic Disease Management Continues to Improve

Performance improved on nearly 80% of chronic disease management measures, with 22 of 28 indicators showing year-over-year gains. One standout trend from this year’s ratings was that MA plans saw significant improvement in Kidney Health Evaluation for Patients With Diabetes (KED), which increased by 7.3 percentage points. Although chronic care performance improved overall, declines in diabetic eye exam performance highlight an area for closer attention and stronger preventive care.

Quality Is Rising as Performance Gaps Narrow

Average benchmark performance increased across commercial, Medicaid and MA, with gains ranging from 1.6 to 1.8 percentage points. Medicaid saw the broadest improvement, with 89% of measures improving year over year. At the same time, variation between high- and low-performing plans decreased across all product lines, suggesting that improvements were widespread rather than limited to top-performing plans.

How Can You Use Ratings?

Ratings serve as a national benchmark for healthcare 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 Children’s Health Insurance Program (CHIP) Quality Rating System goals and stay aligned with CMS Final Rule requirements.
• State and federal programs, including MA, 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, states served) and compare results across multiple plans for health topics such as diabetes, cancer screening or women’s reproductive health.

Learn More

View the 2026 Health Plan Ratings here.

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).