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NCQA’s Health Plan Ratings 2020-2021

NCQA’s Health Plan Ratings 2020–2021 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 Accredited plans. The NCQA Accreditation status used is as of June 30, 2020.

The 2020–2021 ratings is released electronically on September 15, 2020—in time for consumers to use this valuable information when they choose health plans during open enrollment.

Resources for Health Plans

2020 Schedule

Plan Confirmation—Late May

  • (Action Required) Confirmation of the HEDIS and 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 not CAHPS data (or vice versa); or the plan earned an NCQA Accreditation status that does not require HEDIS.
    • 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.

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

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