When it comes to health insurance, a familiar name and lots of members don’t guarantee quality or customer satisfaction, according to new rankings of health-insurance plans from the National Committee for Quality Assurance that we published today. NCQA is an independent health-care quality-measurement group.
The rankings cover 830 private, Medicare, and Medicaid health insurance plans that enroll an estimated 127 million people. Private plans are those that people join through their jobs or buy on their own.
Our analysis of the NCQA rankings found that the five largest national insurers—Aetna, Cigna, Humana, Kaiser Permanente, and United Healthcare, plus the mostly state-based Blue Cross Blue Shield plans—account for about 75 percent of the 390 ranked private plans, but only 36 percent of the top 50.
Here are other highlights:
- Biggest isn’t best. United is the nation’s largest health-insurance company, but none of its private plans rank among the top 100, and most occupy the bottom half.
- Small can be good. For example, Capital Health Plan, a Blue Cross Blue Shield HMO in Tallahassee, Fla., that has just 113,300 enrollees, ranks third in the nation among private plans.
- Kaiser Permanente makes the grade. For instance, its Medicare plans in California, Colorado, Oregon and Washington topped the rankings.
- New England plans excel. Eighteen of the 50 top-ranked private plans are in the six-state New England area. And Aetna and the “Blues” had New England plans that ranked in the top 100, while many of the same insurers’ plans in southern and western states ranked near the bottom.
You might find that the insurance plan you’re currently enrolled in—or interested in joining—isn’t among those we ranked. That’s because some plans don’t submit performance data to NCQA. For example, the 99 Medicaid HMOs ranked this year represent fewer than half the total number of HMOs serving Medicaid enrollees nationwide. In addition, some plans that do submit data choose not to make that information public. Still others submit data but not enough for valid statistical analysis.
The NCQA says its research shows that health that report to the organization and permit their data to be made public tend to do better than non-reporting plans on many quality measures. In addition, choosing a health plan that makes itself accountable puts pressure on all plans to measure their performance and make it available to consumers. So we recommend being skeptical of plans that aren’t ranked, and choosing one that is whenever possible.
For details, see our health-insurance buying guide and the NCQA rankings of health-insurance plans.
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