PROVIDENCE – Tufts Health Plan’s HMO plan in Rhode Island has earned a top rating from the National Committee for Quality Assurance for the 2019-2020 year for its commercial health plan.
NCQA ratings analyzed 438 commercial plans and 171 Medicaid plans nationwide on quality measures, including consumer experience, prevention and treatment, and NCQA accreditation.
NCQA gave Tufts an overall score of 5 out of 5, its highest possible rating, for its HMO/POS plans in Rhode Island and Massachusetts, as well as its PPO plan in the Bay State. Tufts, along with three other health plans in the country, were the sole recipients of NCQA’s 2019-2020 top rating, putting Tufts in the top 1% of plans nationally.
“Collaboration with the provider community is key to assuring that our members receive the coordinated care they deserve,” said Dr. Paul Kasuba, chief medical officer at Tufts Health Plan. “The NCQA review process is very comprehensive, and once again we have demonstrated we are one of the best health plans in the country.”
Blue Cross & Blue Shield of Rhode Island and UnitedHealthcare of New England were just shy of Tufts’ marks, with each company earning a 4.5 rating overall for their PPO plans. UnitedHealthcare earned the 4.5 rating for PPO plans from United Healthcare Services Inc. and Unitedhealthcare Insurance Co.
UnitedHealthcare’s HMO Medicaid plan in Rhode Island received a 4.5 score overall as well. The company’s Medicare HMO plan received a overall rating of 4 out of 5. The NCQA ratings also provided two scores for UnitedHealthcare for Medicare PPO options: United Healthcare Insurance Co. received an overall grade of 3.5, while United Healthcare Insurance Co. – Regional received an overall grade of 3 out of 5.
Neighborhood Health Plan of Rhode Island earned an overall score of 4.5 for its Medicaid HMO plan this year. The company was not included for its private plan in the NCQA ratings.
Elizabeth Graham is a PBN staff writer. She can be reached at Graham@PBN.com.
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