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Top 10 Highest Performing Commercial Health Plans

The highest performing commercial health plans for the 2017-18 plan year invested in consumer satisfaction, preventive care, and chronic disease management.

Highest performing commercial health plans by quality and satisfaction

Source: Thinkstock

By Thomas Beaton

- The top performing commercial health plans in the US for 2017-18 exceeded expectations for customer satisfaction, preventive care, and outcomes of their beneficiaries, according to the National Committee for Quality Assurance (NCQA).

NCQA aggregated HEDIS measures, NCQA Accreditation scores, and Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey scores to rate commercial health plans across the country.

NCQA used a 1-5 scale to rank the nation’s top 10 commercial health plans in the following order:

BlueCross BlueShield of Massachusetts - HMO Blue

  • Overall Rating: 5.0 
  • Scores: Consumer Satisfaction 3.5; Prevention 5.0; Treatment 4.5

BlueCross BlueShield’s HMO Blue plan earned high marks for chronic disease management, and behavioral healthcare, as well as nearly perfect marks for cancer screenings. Consumer satisfaction scores such as primary care provider satisfaction and claims management were slightly lower, but ultimately the plan’s care delivery capabilities brought it to the top spot on the list.

Johns Hopkins US Family Plans - Maryland

  • Overall Rating: 5.0  
  • Scores: Consumer Satisfaction 4.5; Prevention 4.0; Treatment 4.0

John Hopkins US Family Plan beneficiaries were highly satisfied with the ease of receiving care, the quality of their physicians, and the quality of customer service available to them.  The health plan generally performed very well in treatment and prevention scores, with middling performance in observed-to-expected hospital readmissions.

Kaiser Foundation Health Plan - Northern California

  • Overall Rating: 5.0  
  • Scores: Consumer Satisfaction 3.0; Prevention 5.0; Treatment 4.5

The Kaiser Foundation Health Plan received perfect marks for delivering cancer screenings and near perfect marks for heart disease and chronic disease care. However, the plan received deductions because of issues with claims management, health education, and speed of care delivery. Kaiser Foundation Health Plan members received some of the best acute care among all commercial health plans.

Tufts Associated HMO - Massachusetts, New Hampshire, and Rhode Island

  • Overall Rating: 5.0  
  • Scores: Consumer Satisfaction 3.5; Prevention 5.0; Treatment 4.5

Tufts Associated HMO was given a perfect score for quality measures related to childhood and adolescent care and women’s reproductive health, as well as nearly perfectly marks for other preventive services. Tufts Associated consumer satisfaction scores took a minor hit, but the plan excelled in treatment and preventive care to earn it an overall score of 5.0.

Tufts Benefit Administrators - MA

  • Overall Rating: 5.0  
  • Scores: Consumer Satisfaction 3.5; Prevention 4.5; Treatment 4.5

Tufts Benefit Administrators health plan scored nearly perfect in all diabetes and heart disease treatment categories while also earning high marks in mental and behavioral healthcare. The plan’s consumer satisfaction scores were slightly above average in all categories.

Anthem BlueCross BlueShield of Maine

  • Overall Rating: 4.5
  • Scores: Consumer Satisfaction 3.5; Prevention 4.0; Treatment 4.0

Anthem BlueCross BlueShield of Maine earned consistently high marks in behavioral health treatment, chronic disease care, child and adolescent preventive care, and cancer screening. Consumer satisfaction categories scores were slightly above average, but some satisfaction categories including speed of care delivery and members’ rating of care earned industry-leading performance ratings.

Anthem BlueCross BlueShield of New Hampshire

  • Overall Rating: 4.5
  • Scores: Consumer Satisfaction 3.5; Prevention 4.5; Treatment 4.0

BCBS New Hampshire health plans delivered high-quality preventive care and earned perfect scores in cancer screenings and women’s reproductive health. The health plan also earned high ratings for post-hospitalization treatments, but had middling to lower marks for consumer satisfaction. BCBS New Hampshire health plans earned a perfect score in beneficiary health education.

Anthem BlueCross BlueShield of Connecticut

  • Overall Rating: 4.5
  • Scores: Consumer Satisfaction 4.5; Prevention 4.5; Treatment 3.5

BCBS of Connecticut health earned perfect scores in health education, quickness of care delivery, and positive consumer feedback. The health plan earned higher scores in preventive care than chronic disease treatments, but lagged behind in measures such as hospital readmissions and appropriate use of back pain imaging services.

AultCare Insurance Company - Ohio

  • Overall Rating: 4.5
  • Scores: Consumer Satisfaction 5.0; Insufficient Prevention Data; Insufficient Treatment Data

The AultCare Insurance health plan is one of only four health plans in NCQA's commercial directory to earn a 5.0 for consumer satisfaction and perfect scores in every consumer satisfaction category, expect coordination of care. The plan didn’t have enough data to provide overall preventive care and treatment scores, but limited insights show that plan earned higher quality scores in treatment services.

Blue Cross Blue Shield of Rhode Island

  • Overall Rating: 4.5
  • Scores: Consumer Satisfaction 3.5; Prevention 4.5; Treatment 4.0

BCBS of Rhode Island earned high scores for chronic disease prevention and management with just slightly above average scores in consumer satisfaction, as was the case with most BCBS health plans on the list.

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