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Harvard Pilgrim Tops NCQA Rankings for 4th Year

Margaret Dick Tocknell, for HealthLeaders Media, September 25, 2013

This is only the third year that PPOs have been included in the rankings, and they are making their mark. This year 274 commercial PPOs are ranked versus 204 HMOs. In 2012, two of the top 10 plans were PPOs; this year, three PPOs are among  the top 10. There are 11 PPOs in the top 50 this year versus seven last year.

The three Kaiser Foundation Health Plans are the only health plans in the top 10 that are also part of an integrated health system. Kaiser employs its physicians and owns its hospitals, which gives the organization an advantage in delivering coordinated care as well as meeting cost and quality benchmarks.

For-Profit Health Plans
Among the major for-profit health insurers, only Anthem managed to crack the top 25. The HMO offered by Anthem Blue Cross and Blue Shield Maine is ranked at number 23. A Cigna PPO in Massachusetts is ranked 50, an Aetna PPO in Connecticut is ranked 59, UnitedHealthcare's PPO in Rhode Island is ranked 67, and Humana's PPO in Ohio is ranked 132.

Medicare Advantage Health Plans
An HMO from Kaiser Foundation Health Plan of Southern California claimed the top spot among Medicare Advantage health plans. In fact, Kaiser dominates that ranking, with six of its Medicare Advantage plans in the top 10.

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