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September 20, 2013 01:00 AM

Harvard Pilgrim again named best private insurance plan

Rachel Landen
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    For the second year in a row, Harvard Pilgrim Health Care, a not-for-profit insurer based in Wellesley, Mass., topped the rankings for private health insurance plans on the National Committee for Quality Assurance's annual list.

    Using data based on consumer satisfaction, prevention and treatment that was taken from the Consumer Assessment of Healthcare Providers and Systems survey and from the Healthcare Effectiveness Data and Information Set, the NCQA ranked 484 private health plans. In order to be evaluated in the ranking, health plans have to grant permission for the public release of their information and also provide enough data to support a valid analysis. Rankings are based on data submitted by the end of June.

    “All the health plans in these rankings are exemplary,” NCQA President Margaret O'Kane said on the organization's website. “First, they measure their quality in ways that help them improve and that make comparing plans possible. Then they take the extra step of revealing their results for the world to see—a true public service.”

    It is the ninth year that the NCQA has ranked health plans, and the number of participating plans continues to rise each year. “It points to the industry’s increasing openness and use of measurement,” said Andy Reynolds, NCQA vice president for marketing and communications. “More plans have been willing to measure how they’re doing, and just as importantly, they’re willing to be transparent.”

    Though the NCQA has not done a year-over-year comparison of the results, Reynolds did point out that “PPOs continue to inch their way into the upper echelon of health plan performance.

    “They can be high-performing health plans,” Reynolds said.

    In the 2012 rankings, two of the top 10 plans were PPOs; this year, there are three in the top 10. And last year where there were seven PPOs in the top 50, this year there are 11.

    Another common theme among the top 10 plans is geography: Seven are in the six-state region overseen by HHS’ Boston office. “It’s still the case that the HHS Boston region is the place to be if you need healthcare,” Reynolds said.

    And outside of that region, Kaiser Foundation Health Plan appeared in the top 10 three times for its HMOs in the Northwest, Northern California and Ohio.

    The NCQA also released a ranking of 405 Medicare plans and 131 Medicaid plans, evaluated based on the same criteria as the private insurers. Kaiser Foundation Health Plan claimed the first five spots on the Medicare list, with its Southern California plan in the top spot for the second consecutive year. And for the sixth time in the past seven years, Fallon Community Health Plan, Worcester, Mass., was the winner among Medicaid plans.

    The NCQA will follow up on the announcement of these rankings with the publication of its annual State of Health Care Quality Report next month. The Oct. 23 release provides a “rolled-up, aggregated national snapshot” of the U.S. healthcare system, according to Reynolds, as opposed to the granular view afforded by the health plan rankings.

    Follow Rachel Landen on Twitter: @MHrlanden

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        • - Hospital of the Future (Fall)
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