5 Slide Series

5 Slide Series

NCQA State Averages for Medicaid, Medicare, and Private Health Plans
Publication Date: Feb 28, 2014
Summary

This edition of the Series tabulates state average NCQA quality scores across the health plans that have been rated by NCQA.  Separate averages have been calculated for Medicaid health plans, Medicare plans, and private plans.  The key findings from our analyses are that:

  1. States that rank well in one payer sector (e.g. Medicare) tend to also rank well in others
    • Three states rank among top ten in all three sectors: Massachusetts, Rhode Island, and Pennsylvania
  1. It appears the geographic area itself plays a role in the health plans’ quality scores
    • Underlying provider and patient behaviors are likely contributing factors to the scores health plans are achieving
    • The same health plan investment in staff and systems to achieve optimal HEDIS scores, for example, will likely yield different results in different geographic areas

Presentation