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Secrets of the Top Private Health Insurers

 |  By Cora Nucci  
   October 13, 2010

The National Committee for Quality Assurance recently issued its annual rankings of private health insurance plans for 2010-2011. NCQA evaluated over 300 private health plans and ranked 227 of those based on clinical performance, member satisfaction, and NCQA Accreditation. 

At a glance, the results come as no big shock; the top 20 are chock full of most the usual suspects. But there are a few interesting tidbits to glean from the list:

  • Harvard Pilgrim came in at #1 for the fifth consecutive year.  But in 2000, in the throes of financial difficulties, Harvard Pilgrim entered into receivership for 6 months.  The CEO at the time, Charlie Baker, today is a Republican candidate for Massachusetts governor, in what is turning out to be a lively race.
  • #2 Tufts Health Plan was co-founded by Staples co-founder Tom Stemberg. The office supply retailer said in a recent interview that " [former Massachusetts Governor and presidential candidate] Mitt Romney credits me with having given him the idea of covering every citizen in the state."
  • Former #5 Geisinger Health Plan CEO Richard Gilfillan, MD, was named Acting Director of the new CMS Innovation Center by CMS Administrator Don Berwick on September 27.
  • #8 Fallon Community Health Plan is bringing back house calls.
  • #15 Health Net of Connecticut and its affiliates reached a whopper of a settlement with the state of Connecticut in July over the failure last year to secure the private medical records of 1.5 million policyholders and for the insurers' delay in reporting the breach. Connecticut Attorney General Richard Blumenthal said the settlement imposes a $250,000 fine on the company for HIPAA and HITECH violations.
  • UnitedHealth Group's first appearance isn't in the top 20. Or the top 50. It squeaks in at #60 as  UnitedHealthcare of New England.  But it gained 1 million members last month by absorbing the customers of the Principal Financial Group, which left the business.

The detailed report, all 241 pages of it, is here.  NCQA drills down in three major areas:  consumer satisfaction, prevention, and treatment, and assigns each plan a numeric rank determined by its combined HEDIS, CAHPS and NCQA accreditation standards scores.  
NCQA expects to have Medicaid and Medicare plan rankings online by early November and is exploring options to rank preferred provider organizations in 2011. Stay tuned.

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