WATERTOWN, Mass.--(BUSINESS WIRE)--Tufts Health Plan today announced it is rated 5 out of 5 by the National Committee for Quality Assurance (NCQA) on its annual rating of private health insurance plans.* Tufts Health Plan is the only health plan in the nation to receive the rating for both its HMO and PPO products. Tufts Health Plan PPO is the only PPO plan in America to receive the 5 out of 5 rating. Tufts Health Plan’s Medicaid plan achieved a 4.5 rating by NCQA.**
“We strive to deliver superior, high value health plans to the diverse communities we serve,” said Tom Croswell, Tufts Health Plan President and CEO. “These outstanding ratings are the culmination of hard work performed across our entire organization.”
The NCQA ratings, which rate 500 private commercial plans and close to 200 Medicaid plans, are based on quality measures from three performance subcategories—consumer experience, prevention and treatment—and NCQA accreditation.
"We owe a great deal of thanks to the provider community for their help in ensuring our members receive the coordinated, high quality care they deserve,” said Paul Kasuba, MD, Tufts Health Plan Chief Medical Officer. “NCQA is a very competitive program, and once again we have proven we are one of the best health plans in the country.”
This is the 12th consecutive year that Tufts Health Plan has ranked among the highest-rated private health insurance plans in the nation by NCQA and the 7th consecutive year that its Medicaid plan has been ranked 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. We are true to our mission of improving the health and wellness of the diverse communities we serve. Touching the lives of more than one million members, Tufts Health Plan serves members in Massachusetts and Rhode Island through employer-sponsored plans; Medicare; and Medicaid and marketplace plans, offering health insurance coverage across the life span regardless of age or circumstance. Through our acquisition of Integra Partners and its network, we are proud to serve an additional 15 million members across 19 states.
In addition to the NCQA quality ratings, Tufts Medicare Preferred HMO and Senior Care Options earned a 5 star rating from the Centers for Medicare and Medicaid Services (CMS) for 2016, putting it at the top of Medicare plans nationally.
*NCQA’s Private Health Insurance Plan Ratings 2016–2017
**NCQA’s Medicaid Health Insurance Plan Ratings 2016–2017