Nonprofit Health Plans Outperform For-Profit Plans on Quality of Care

November 30, 2011; Source: The HillNo surprise to us, but in the latest annual National Committee for Quality Assurance ranking of the quality of care of Medicare and Medicaid health plans, nonprofit plans were by and far rated the best. According to the Alliance for Advancing Nonprofit Health Care, all of the top 10 private plans, 68 percent of the top quartile of plans, and 76 percent of the top quartile of Medicaid plans were nonprofit. Very detailed report cards on the individual plans may be viewed at the NCQA website (for example, this report card on Kaiser Permanente of Northern California). Below are the top plans in both categories:

TOP 10 MEDICARE HEALTH PLANS

TOP 10 MEDICAID HEALTH PLANS

1. Kaiser Foundation Health Plan of Northern California (HMO)

1. Fallon Community Health Plan (HMO)

2. Kaiser Foundation Health Plan of Southern California (HMO)

2. Kaiser Foundation Health Plan of Hawaii (HMO)

3. Kaiser Foundation Health Plan of Colorado (HMO)

3. Boston Medical Center HealthNet Plan (HMO)

4. Kaiser Foundation Health Plan of the Northwest(HMO)

4. Neighborhood Health Plan (HMO)

5. Gundersen Lutheran Health Plan (HMO)

5. Capital District Physicians’ Health Plan (HMO)

6. Capital Health Plan (HMO)

6. Security Health Plan of WI (HMO)

7. Kaiser Foundation Health Plan of Hawaii (HMO)

7. Network Health (HMO)

8. Tufts Associated Health Maintenance Organization (HMO)

8. Neighborhood Health Plan of Rhode Island (HMO)

9. Geisinger Gold Classic (HMO)

9. Priority Health (HMO)

10. Kaiser Foundation Health Plan of the Northwest (Demonstration Project) (HMO)

10. UPMC For You (HMO) 

NCQA evaluated over 403 Medicare health plans and ranked 341 of those based on clinical performance, member satisfaction and NCQA Accreditation.

NCQA evaluated over 213 Medicaid health plans and ranked 99 of those based on clinical performance, member satisfaction and NCQA Accreditation

Perhaps there is a message for health care reform in this NCQA listing, the first of which should be that health plans should reveal to consumers whether they are for-profit or nonprofit.—Rick Cohen