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Shopping for a Health Plan During Open Enrollment Season?

November 2, 2016 · NCQA Communications

Shopping for a Health Plan During Open Enrollment Season?

Shopping for a Health Plan During Open Enrollment Season?

During this open enrollment season, millions of Americans are shopping for a health insurance plan that best fits their needs. The National Committee for Quality Assurance (NCQA) is here to help. We created a ratings system that provides shoppers with a more accurate picture of how health plans perform in the key quality areas of consumer satisfaction, prevention and treatment.

NCQA’s Health Insurance Plan Ratings 2016–2017 compare the quality and services of more than 1,000 health plans in the United States and is a valuable tool for consumers during open enrollment season.

About the Ratings:

NCQA studied 1,401 health plans and rated 1,012: 503 private (commercial), 338 Medicare and 171 Medicaid. The ratings are a system similar to the Centers for Medicare and Medicaid Services (CMS) Star Ratings of Medicare Advantage plans, and give unprecedented importance to health outcomes and consumer satisfaction.

How Can Health Plan Ratings Help You?

The ratings are broken into three major performance categories: consumer satisfaction, prevention and treatment. You can see how the health plans perform in each of these areas and decide which is most important to you.
• Consumer Satisfaction: What patients say about their health plans in satisfaction surveys, including care, customer service and physicians.
• Prevention: How well plans provide screenings, immunizations and other preventive services.
• Treatment: How well a plan performs in treating chronic and acute conditions such as diabetes, depression and heart disease.

In each category, the results—outcomes—of a patient’s care count extra in the scoring; for example, whether blood pressure and diabetics’ blood sugar are controlled to safe, recommended levels.

This emphasis on results means that, together with consumer satisfaction, outcomes are the main driver of ratings results.
NCQA’s Health Insurance Plan Ratings are available by visiting: http://healthinsuranceratings.ncqa.org/2016/Default.aspx


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