NCQA’s Health Plan Ratings 2022

RESOURCES FOR HEALTH PLANS

NCQA’s 2022 Health Plan Ratings include 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 a current Accreditation status as of June 30, 2022.

The 2022 Ratings were released electronically on September 15, 2022—Consumers used this valuable information when they chose health plans during open enrollment.

2022 Health Plan Ratings in Excel Format (Internal Use Only).
2022 Methodology: How we calculated the ratings (last updated July 29, 2022).
2022 Measure List: A list of required Performance Measures (last updated July 28, 2022). View details for years of data used.
Advertising and Publicity Guidelines: Rules for promoting results.
Frequently Asked Questions about HPR vs. CMS Star Ratings.
Medicare Advantage CAHPS Guidance.
Scoresheet Instructional Video.
Previous Health Plan Ratings.

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2022 Schedule

Plan Confirmation—Early 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—Late August/Early September

A private release of final ratings to all plans.

NCQA Releases Ratings—On or around 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