Just Two Health Plans Earned 5 Stars In New 2023 Health Plan Ratings

by Aditya Kumar

The National Committee for Quality Assurance (NCQA) recently released its 2023 Health Plan Ratings, providing valuable insights into the quality of health insurance plans in the United States. While there are signs of improvement, the data supports the widely held belief that Americans have a negative perception of health coverage in the country.

According to Gallup’s Health and Healthcare poll, nearly 68% of Americans rate health coverage in the United States as fair or poor. The NCQA’s latest ratings seem to reinforce this sentiment. Out of the nearly 1,100 health plans that reported data to the NCQA, only two plans earned the top rating of 5 stars. While this may sound concerning, it is actually an improvement compared to last year, when only one plan achieved this feat.

The two health plans that earned 5 stars in this year’s ratings are Kaiser Foundation Health Plan of the Mid-Atlantic States and Independent Health Association based in New York. Kaiser Foundation Health Plan of the Mid-Atlantic States also earned 5 stars across all three insurance segments in last year’s ratings. These plans attained the highest rating primarily by improving their patient experience results. Members gave the plans high ratings for factors such as ease of accessing care, coordination between primary care doctors and other providers, and overall satisfaction.

It is important to note that the 5-star ratings were exclusive to commercial plans this year. None of the Medicare or Medicaid plans achieved a 5-star rating. However, there was a positive development among Medicaid plans, which serve lower-income individuals and people with disabilities. The number of Medicaid plans that earned 4 or 4.5 stars increased by nearly 6%, indicating some improvement in quality. However, Reynolds suggests that Medicaid plans need to focus on improving care for chronic conditions, as this aspect is currently their weakest area.

Overall, the commercial and Medicare segments performed better than Medicaid. Approximately 27% of the 591 commercial plans scored 4 stars or higher, while only two plans earned 1.5 or 2 stars. Among the 674 Medicare plans included in the ratings, 151 (22%) scored 4 or 4.5 stars, but none achieved the highest rating of 5 stars. Eleven Medicare plans scored the lowest rating of 2 stars.

One of the key takeaways from the NCQA’s Health Plan Ratings is the significant variation in health plan quality. Reynolds emphasizes that health insurance is not a commodity and that one plan is not necessarily the same as another. However, many consumers do not have a choice of plans, as 75% of companies that offer employee health benefits provide only one type of plan. On the other hand, Medicare enrollees have multiple options, with an average of 43 Medicare Advantage plans available to them.

For consumers who do have a choice, Reynolds encourages them to use their selection process to drive quality. By enrolling in plans that deliver good care, people can hold health plans accountable and incentivize them to continuously improve their services. Consumers can access the NCQA’s website to check how their health plan or the plans they are considering stack up. It is crucial to dig into the specific measures that matter most, such as recommended screenings and treatments for specific conditions and member satisfaction.

In conclusion, while the NCQA’s 2023 Health Plan Ratings show some improvement in health plan quality, there is still much work to be done. With only two plans earning the highest rating of 5 stars, it is clear that there is room for improvement across the board. Consumers should remain vigilant in their selection process and prioritize plans that provide high-quality care and excellent patient experiences.

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