In a press statement announcing its ranking, Harvard Pilgrim officials credited the health plan's clinical programs and customer service with its NCQA performance. "We are committed to encouraging exceptional patient/physician relationships and offering product innovations to address the many challenges faced by patients and providers today," Eric Schultz, president and CEO of Harvard Pilgrim, said in the statement.
Nonprofits once again claimed every spot on the top 10 list of private plans. NCQA officials attribute the nonprofit standing to their independence from investors. "Their nonprofit mission and member focus makes it easier for them to deliver care in ways that really benefit their members. They don't have to satisfy investors with growing profits," Sarah Thomas, vice president of public policy and communications for NCQA, told HealthLeaders Media during a telephone call.
CR's Top Health Plans
In addition to Harvard Pilgrim, the top 10 list includes HMO/POS products from Tufts Health Plan (Massachusetts), Kaiser Foundation Health Plans (Colorado), and Northern and Southern California, Capital Health Plan (Florida), and Group Health Cooperative (Wisconsin).
Five of the top plans are integrated health systems (IHS) that employ physicians and even own hospitals that care for their customers. The IHS makes it somewhat easier to control the delivery of care as well as cost and quality because the system has physicians, nurses, and others "who talk to each other and work together toward quality goals," explains Thomas. The IHSs are Capital Health Plan, Group Health Cooperative, and the Kaiser Foundation Health Plans.