OAKLAND, Calif. — Kaiser Permanente’s Medicare and commercial health plans in Northern California, which serve nearly 4 million members, received the highest ratings from the National Committee for Quality Assurance, a national group that rates health plans for consumer experience, prevention and treatment.
In a report published on September 20, 2016, NCQA Health Plan Ratings for 2016-17, Kaiser Permanente was rated 5 out of 5, the only health plan in the country to receive the highest rating for both Medicare and private plans. The group analyzed over 1,000 health plans in the nation — private, Medicare, Medicaid — for quality and service. Only 23 plans received the highest rating.
The Northern California region’s health plan was one of eight Kaiser Permanente Medicare plans that received the 5 rating, out of 338 Medicare plans rated. The Kaiser Permanente Northern California health plan tied with Kaiser Permanente Southern California for the highest rating in the state and among the top three percent in the nation. Other Kaiser Permanente Medicare health plans in the Pacific Northwest, Georgia and Hawaii also rated 5.
Kaiser Permanente Northern California’s commercial health plan also rated a 5, as did Kaiser Permanente Mid-Atlantic States. Only 13 commercial health plans in the country, out of 503 rated by NCQA, received the highest rating.
NCQA is a national, private not-for-profit organization that surveys health plans for performance in a wide range of clinical service measures. All Kaiser Permanente health plans were rated 4 or higher.
Robert Pearl, MD, executive director and CEO of The Permanente Medical Group, said that being the only organization in the nation to receive this recognition is remarkable, and reflects the superiority of our model.
“None of this success would have been possible without the excellence of our physicians and staff, and our nation leading technology,” said Dr. Pearl. “We know our focus on prevention, early intervention and sophisticated centers of clinical excellence for the most complex diseases makes a huge difference in the lives of our patients. It’s not a coincidence our members have a lower chance of dying from heart disease, cancer and strokes than patients outside of Kaiser Permanente.”
“This recognition as a top-rated health plan reflects our drive to provide the affordable, high quality health care coverage our members expect and deserve,” said Janet Liang, president, Kaiser Permanente Northern California region. “Our care teams are passionate about quality care and service and their dedication is reflected in these results.”
The NCQA’s Health Insurance Plan Ratings are based on combined scores for health plans in Healthcare Effectiveness Data and Information Set®, commonly called HEDIS; the Consumer Assessment of Healthcare Providers and Systems®, or CAHPS; and NCQA Accreditation standards scores.
This is the 12th year NCQA has ranked or rated the nation’s health plans. From 2005-14, NCQA ranked the plans numerically from highest to lowest. Last year, for the first time, NCQA implemented a “ratings” system which classifies plans into scores from 0-5 in 0.5 increments. It is a method similar to the Centers for Medicare and Medicaid Service’s 5-Star Quality Rating System.
The ratings and methodology are posted on the NCQA’s website at www.ncqa.org and soon will be available on WebMD.com.
This article appeared on Kaiser Permanente’s Share site on September 20, 2016.