WATERTOWN, Mass., Sept. 21, 2017 /PRNewswire/ -- Tufts Health Plan today announced it is rated 5 out of 5 – the highest rating possible – by the National Committee for Quality Assurance (NCQA) on its annual rating of private health insurance plans.* It is the only health plan in the nation to receive the 5 out of 5 rating for both its HMO and PPO products.* Only three other plans in the country, from a pool of nearly 500 -earned a rating of "5." Its Massachusetts PPO is the only PPO plan in the country to receive a 5 out of 5 rating.
Tufts Health Plan also announced its Massachusetts Medicaid plan achieved a 4.5 rating by NCQA, placing it amongst the top health plans nationally.** Only 10 Medicaid plans received a 4.5 rating, out of the nearly 300 evaluated.
"It takes a significant commitment to be awarded the highest quality ratings from the NCQA," said Tom Croswell, Tufts Health Plan president and CEO. "I am extremely proud of the hard work performed across our entire organization and the discipline from every Tufts Health Plan employee, as well as our collaborative provider community, to ensure our plans offer high value to our members."
The NCQA ratings, which rate close to 500 private commercial plans and 200 Medicaid plans, are based on quality measures from three performance subcategories—consumer experience, prevention, and treatment—and NCQA accreditation.
"We continue to work closely with the provider community to ensure that our members receive quality, coordinated care," said Paul Kasuba, MD, Tufts Health Plan chief medical officer. "Our dedication to our members is evident in our success as we strive to deliver quality coverage year after year. Once again we have proven we are one of the best health plans in the country."
This is the 13th consecutive year that Tufts Health Plan has been among the highest-rated private health insurance plans in the nation by NCQA and the 8th consecutive year that its Medicaid plan has been among the highest-rated plans by NCQA.
NCQA is a private, non-profit 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.
About Tufts Health Plan
Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage. Staying true to our mission of improving the health and wellness of the diverse communities we serve, we touch the lives of more than 1.1 million members in Massachusetts, Rhode Island and New Hampshire through employer-sponsored plans; Medicare; Medicaid and Marketplace plans, offering health insurance coverage across the life span regardless of age or circumstance.
We are continually among the top health plans in the country based on quality and member satisfaction:
- Our private HMO and Massachusetts PPO plans are rated 5 out of 5 and our Medicaid plan is rated 4.5 out of 5 by the National Committee for Quality Assurance.i
- Our Tufts Medicare Preferred HMO and Senior Care Options plans received a 5-star rating from the Centers for Medicare & Medicaid Services, the highest rating possible.ii
*NCQA's Private Health Insurance Plan Ratings 2017–2018; Tufts Health Plan's HMO/POS plan rated a 5 out of 5; Tufts Health Plan's PPO plan in Massachusetts rated a 5 out of 5. Tufts Health Plan's PPO plan in Rhode Island rated a 4 out of 5.
**NCQA's Medicaid Health Insurance Plan Ratings 2017–2018. This rating references Tufts Health Plan's Massachusetts Medicaid plan. Tufts Health Plan's Rhode Island Medicaid plan has not yet been rated
i The National Committee for Quality Assurance Private Health Insurance Plan Ratings and Medicaid Health Insurance Ratings2017-2018. This rating references Tufts Health Plan's Massachusetts Medicaid plan. Tufts Health Plan's Rhode Island Medicaid plan has not yet been rated.
ii Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov. Tufts Medicare Preferred HMO plans received 5 out of 5 stars for contract year 2016 and 2017.
Contact: Kathleen Makela
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SOURCE Tufts Health Plan