Community-Based Health Plans Lead in 2010 Quality Rankings

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Oct 26, 2010, 12:13 ET

ACHP Members Comprise 9 of Top Ten Medicare Plans and 4 of Top Ten Medicaid Plans

WASHINGTON, Oct. 26 /PRNewswire-USNewswire/ -- Nineteen members of the Alliance of Community Health Plans (ACHP) have been named as among the nation's best Medicare health plans, while seven ACHP members are ranked among the top Medicaid plans, as measured by the National Committee for Quality Assurance's (NCQA) Health Insurance Plan Rankings – 2010-11 - Medicare/Medicaid.

In the 2010-2011 rankings of nearly 200 Medicare plans, ACHP members occupy nine of the top 10 spots of highest performing Medicare plans. Of more than 100 Medicaid plans in the United States that reported data, four ACHP members rank among the top ten highest-performing Medicaid plans, and seven were included in the top 25. NCQA ranks health plans based on clinical performance, member satisfaction and NCQA accreditation.

ACHP has 21 community-based health plans and provider organizations as members, almost all of which were named in the top 50 Medicare plans and eight were ranked in the top 50 Medicaid plans. Last month, NCQA ranked 11 ACHP member plans in its list of the top 25 commercial health plans in the nation.

"We're honored and pleased that our plans have won this distinction. It's a reflection of their focus on patients, close partnerships with physicians, and clinical excellence," said Patricia Smith, ACHP President and CEO. "These ACHP members have invested in the long-term health of their communities and their commitment has resulted in their Medicare enrollees receiving high quality care."

In the NCQA rankings, Capital Health Plan (CHP) of Tallahassee, Fla., was designated the No. 1 ranked Medicare Advantage Plan in the nation. CHP's Medicare Advantage Plan is the first Florida health care plan ever to be ranked in the top spot. "As the only health care plan in Florida to receive such a commendable rating, we are committed to being a leader and continually improving Medicare services and patient care," said John Hogan, CEO of Capital Health Plan. "The rankings we received from the National Committee for Quality Assurance are a testament to the dedication of our staff and medical community to excellent care for our members."

The NCQA rankings are based on data from the Health Plan Employer Data and Information Set (HEDIS®), the Consumer Assessment of Healthcare Providers and Systems (CAHPS®), and Medicare's Health Outcomes Survey for Medicare Advantage. HEDIS® measures are administered by NCQA and are used to determine the quality of care patients receive. They track a wide range of services, including appropriate asthma and bronchitis medication use, diabetes care and breast cancer screening. Health plans use HEDIS® measures to identify areas for improvement in delivering care.

CAHPS® measures are administered by the U.S. Agency for Healthcare Research and Quality and are used to determine the level of patient satisfaction with the care and experience with providers and health care facilities. CAHPS® measures allow patients to identify aspects of care they believe are strong or in need of improvement.

This year, 183 Medicare and 104 Medicaid health plans voluntarily reported their data to NCQA.

ACHP Member Plans Among Highest Ranked Plans in 2010 - 2011

Medicare Plans – Top 25
Rank – Plan
1 Capital Health Plan
2 Kaiser Foundation Health Plan of Colorado
3 Fallon Community Health Plan
4 Kaiser Foundation Health Plan of the Northwest
5 Kaiser Foundation Health Plan of Southern California
6 Security Health Plan of Wisconsin
7 Tufts Associated Health Maintenance Organization
8 Kaiser Foundation Health Plan of Northern California
10 Geisinger Health Plan
11 Group Health Cooperative
12 Kaiser Foundation Health Plan of Hawaii
14 Kaiser Foundation Health Plan of Northwest (Demonstration Project)
15 Capital District Physicians' Health Plan
18 Independent Health Association
19 Kaiser Foundation Health Plan of the Mid-Atlantic States

Medicaid Plans – Top 25
Rank – Plan
1 Fallon Community Health Plan
2 Kaiser Foundation Health Plan of Hawaii
6 Capital District Physicians' Health Plan
10 UPMC For You
12 Priority Health
14 Independent Health Association
16 HIP Health Plan of New York (EmblemHealth)

Commercial Plans – Top 25
Rank – Plan
2 Tufts Associated Health Maintenance Organization
4 Capital Health Plan
5 Geisinger Health Plan
7 Group Health Cooperative of South Central Wisconsin
8 Fallon Community Health Plan
9 Kaiser Foundation Health Plan of Colorado
13 Priority Health
16 Independent Health Association
19 HealthPartners
21 Kaiser Foundation Health Plan of Northern California
22 ConnectiCare (EmblemHealth)

About the Alliance of Community Health Plans

ACHP is a national leadership organization that brings together innovative health plans and provider groups that are among America's best at delivering affordable, high-quality coverage and care in their communities. The community-based and regional health plans and provider organizations from across the country that make up ACHP's membership provide coverage and care for approximately 18 million Americans. These 21 organizations focus on improving the health of the communities they serve and are on the leading edge of patient care coordination, patient-centered medical homes, accountable health care delivery, use of information technology and other innovations leading to improvements in affordability and the quality of care. To learn more about ACHP, go to www.achp.org.

ACHP and its members improve the health of the communities we serve and actively lead the transformation of health care to promote high quality, affordable care and superior consumer experience.

About the National Committee for Quality Assurance

Celebrating its 20th anniversary in 2010, NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers, and researchers.