RESOURCES FOR HEALTH PLANS
NCQA’s Health Plan Ratings 2021 includes commercial, Medicare and Medicaid health plans. The overall rating is the weighted average of a plan’s HEDIS® and CAHPS® measure ratings, plus bonus points for plans with current Accreditation status as of June 30, 2021.
The 2021 ratings will be released electronically on September 15, 2021—in time for consumers to use this valuable information when they choose health plans during open enrollment.
- 2021 Methodology (updated 12/18/2020): How we will calculate the ratings for 2021.
- 2021 Measure List (updated 3/16/2020): A list of required Performance Measures.
- Frequently Asked Questions about HPR vs CMS Star Ratings.
- Medicare Advantage CAHPS Guidance.
- Previous Health Plan Ratings.
Plan Confirmation—Late May
- (Action Required) Confirmation of HEDIS/CAHPS submissions and other information used (e.g., organization name, states, Accreditation status) to calculate ratings. Plans have 10 business days to confirm.
HEDIS and CAHPS Submission—June 15
- This submission deadline is defined in the HEDIS Volume 2 Technical Specifications.
Projected Ratings—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 did not submit CAHPS data (or vice versa); or the plan earned an NCQA Accreditation status that does not require submission of HEDIS data.
- 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 15,000 members.
- Plans have 10 business days to confirm their information.
Final Ratings—Early September
- A private release of final ratings to all plans.
NCQA Releases Ratings—September 15
- Final ratings posted at www.ncqa.org
- Embargo on plan rating-related promotions ends at 6pm ET; plans may begin advertising their ratings at this point.
Questions? Contact NCQA’s Health Plan Ratings Help Desk at my.ncqa.org