National Committee for Quality Assurance releases 2015 health plan ratings

Four areas of mental and behavioral health are included in the ratings.

Using a new methodology designed to provide consumers with a more accurate picture of performance, the National Committee for Quality Assurance (NCQA) has released its 2015 – 2016 ratings of health insurance plans. Although primarily focused on private insurance plans the NCQA ratings also include hundreds of Medicare and Medicaid health plans.

NCQA looked at more than 1,000 plans covering 138 million people across the country. The ratings focus on three important areas: consumer satisfaction, prevention and treatment. The goal is to show how consistently a plan provides recommended care for common but costly conditions. 

Of particular interest to psychologists, NCQA provides ratings on treatment for four areas of mental and behavioral health:

  • Depression: Adhering to medication for 12 weeks.
  • Follow-up after hospitalization for mental illness.
  • Alcohol or drug dependence treatment initiated.
  • Follow-up after ADHD diagnosis.

The ratings’ simple format is comparable to the star ratings used by the Centers for Medicare and Medicaid Services. Plans receive ratings from 1 (lowest) to 5 (highest), making the results easy for consumers to view and understand.

NQCA found that most health plans had ratings in the middle, with plans rarely rated either very high or very low. According to NCQA, if plotted on a graph the results would resemble a bell curve. Five of the six New England states (Maine, Massachusetts, New Hampshire, Rhode Island and Vermont) were among the highest performers, receiving ratings of 4.5 or higher.

In addition to a plan’s overall rating, NCQA provides more detailed information about consumer satisfaction, prevention and treatment. When looking at the ratings online, consumers can link to specifics about each plan’s performance in these three key areas. For example, instead of just seeing how a particular plan is rated for treatment, the public can learn more about how the plan scored on treatment for specific diseases.

Psychologists can view the ratings on the NCQA website.