Consumer Reports released on Monday its annual health plan rankings. For the third consecutive year an HMO operated by Massachusetts-based Harvard Pilgrim Health Care was the top-ranked private plan. Harvard Pilgrim has three plans in the top 10: its PPO ranked fifth and its New Hampshire HMO was ranked seventh.
The rankings are compiled by the National Committee for Quality Assurance, a nonprofit health care accreditation and quality measurement group. The scores take into account customer satisfaction, prevention, and treatment, including Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) performance measures.
Each plan receives an overall score between 1 and 100. Prevention and treatment account for 60% of the score, consumer satisfaction for 25%, and NCQA accreditation for 15%.
This year's findings rank 978 health plans, including 474 private plans, 395 Medicare Advantage plans, and 115 Medicaid HMOs. NCQA accreditation is voluntary, although health plans pay for the process. Beginning in 2014, all health plans that participate in health insurance exchanges must be accredited.