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Medicare News
Best Health Plan Ranking Includes Those Covering
Medicare, Medicaid
U.S. News & World Report, NCQA release annual
rankings for 500 health plans
 Oct. 27, 2007 A ranking for U.S. health
maintenance organizations and point-of-service plans was released today,
which includes plans that serve Medicare and Medicaid. The U.S. News &
World Report listing, however, may not be of much help to those who
dont live in the northeast since that is where all but one of the top
ten plans serving those in the government programs are located.
The magazine and the National Committee for Quality
Assurance (NCQA) unveiled the third edition of America's Best
Health Plans. Coinciding with the November launch of "open season," when
many families face health plan selection options, the rankings will be
published in the November 5 issue of U.S. News, on newsstands as of
Monday, October 29 and online beginning Friday, October 26, at 12:01
a.m. Eastern Time.
The Medicare open enrollment period, which allows
beneficiaries to make changes to their coverage, begins November 15
The 2007 online edition of America's Best Health
Plans includes data and information on nearly 550 commercial, Medicare,
and Medicaid health plans, as well as identifying 150 plans that chose
to report no data.
The rankings are based on more than 100 aspects of
clinical performance, such as a plan's ability to help diabetic members
meet a blood pressure target number, and customer satisfaction, such as
how satisfied members are with specialists they see.
The evaluation uses data submitted annually to NCQA.
Some results came from a consumer survey asking
members how satisfied they were, for example, with how well their
doctors communicated with them and how quickly care was provided.
The types of plans evaluated include
● HMO: Health
maintenance organization; primary-care physicians provide routine care
and a specialist network provides other care; care outside the network
is paid out of pocket.
● POS:
Point-of-service plan; a POS plan pays some of the cost of
out-of-network care.
"America's Best Health Plans is a practical tool
that helps consumers make informed decisions when choosing a health
plan," said NCQA President Margaret E. O'Kane. "It lets consumers know
which plans have demonstrated they can deliver the highest levels of
care and service."
Avery Comarow, a U.S. News senior writer and the
editor of America's Best Health Plans said, "It's hard to be a health
consumer these days. While there is no shortage of information, not all
of it is clear and trustworthy. The health plan rankings are one of many
ways U.S. News tries to give consumers data that is accurate, easy to
understand, and relevant to their and their families' health."
Below are highlights of the 2007 rankings:
Note: HMO = health maintenance
organization; POS = point-of-service plan
Top 5 Medicare Plans
1. Fallon Community
Health Plan HMO), Mass.
2. Blue Cross and Blue
Shield of Massachusetts (HMO)
3. Tufts Associated
Health Maintenance Organization (HMO), Mass.
4. Preferred Care (HMO),
N.Y.
5. Kaiser Foundation Health Plan of the Northwest
(HMO), Ore., Wash.
Top 5 Medicaid Plans
1. Fallon Community
Health Plan (HMO), Mass.
2. Neighborhood Health
Plan Rhode Island (HMO)
3. Blue Cross & Blue
Shield of Rhode Island (POS)
4. Capital District
Physicians' Health Plan (HMO), N.Y.
5. Excellus BlueCross BlueShield, Rochester Region
(HMO), N.Y.
Top 10 Commercial Plans
1. Harvard Pilgrim
Health Care (HMO/POS*), Maine, Mass.
2. Tufts Associated
Health Maintenance Organization (HMO/POS), Mass., N.H., R.I.
3. Harvard Pilgrim
Health Care of New England (HMO/POS), N.H.
4. Blue Cross and Blue
Shield of Massachusetts (HMO/POS)
5. ConnectiCare
(HMO/POS), Conn.
6. Health Net of
Connecticut (HMO/POS)
7. Excellus BlueCross
BlueShield, Rochester Region (HMO/POS), N.Y.
8. Group Health
Cooperative of South Central Wisconsin (HMO)
9. Health New England
(HMO/POS), Conn., Mass.
10. Anthem Blue Cross and Blue Shield - of
Connecticut (HMO/POS)
Source: U.S. News & World Report - Web site:
http://www.usnews.com/
Editors Notes:
About 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 and recognizes physicians in
key clinical areas. 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 through the Web, media and data licensing agreements in
order to help consumers, employers and others make more informed health
care choices.
About U.S.News & World Report
Founded in 1933, the weekly national news
magazine U.S.News & World Report is devoted to investigative journalism
and reporting and to analyzing national and international affairs,
politics, business, health, science, technology, and social trends.
Through its annual rankings of America's Best Colleges, America's Best
Graduate Schools, America's Best Hospitals, America's Best Children's
Hospitals, America's Best Health Plans, and America's Best Leaders, as
well as its News You Can Use(R) brand, U.S. News has earned a reputation
as the leading provider of service news and information that improves
the quality of life of its readers. Available online at www.usnews.com,
the U.S. News website extends that brand promise and delivers the best,
most accurate information on the Web, organized in a way that is
accessible and easy to use.
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