Publication
The Elevance Health Public Policy Institute engaged and worked with us to assess the degree to which quality scores on pharmacy-related measures were affected by the state’s Medicaid managed care program design features. The key issue assessed was whether quality scores were better in states where the prescription drug benefit was “carved-in” rather than “carved-out.” We created 34 group comparisons between the two settings, and consistently found the Medicaid MCO quality scores to be superior in the carve-in setting. This finding occurred across years, across a wide set of behavioral health and physical health HEDIS measures, and in different regions of the country.
5-Slide Series
The September and October editions of our 5 Slide Series provides our tabulations and analysis of the NCQA Quality Ratings for Medicaid MCOs (September edition) and Medicare MCOs (October edition) in Rating Year 2019-2020. We looked at the national distribution of MCO ratings, calculated average ratings for large multi-state chain MCOs, and reported the highest rated plan in each state (or plans if there was a tie).
5-Slide Series
The September and October editions of our 5 Slide Series provides our tabulations and analysis of the NCQA Quality Ratings for Medicaid MCOs (September edition) and Medicare MCOs (October edition) in Rating Year 2019-2020. We looked at the national distribution of MCO ratings, calculated average ratings for large multi-state chain MCOs, and reported the highest rated plan in each state (or plans if there was a tie).
5-Slide Series
The August 2019 edition was produced by Grace Williams and summarizes our analyses of NCQA’s most recent quality ratings for commercial/private MCOs. Kaiser Permanente led the multi-state MCOs with a stellar 4.28 average rating, scoring over half a point higher than the 2nd place MCO and scoring more than ¾ of a point higher than the national average.
5-Slide Series
October’s edition conveys some of our tabulations working with the recently published NCQA Medicaid health plan quality ratings for Rating Year 2018-2019. AmeriHealth Caritas and UnitedHealthcare are the two top-rated national chain organizations in terms of their average NCQA rating across the states they serve. Among the 13 Medicaid MCOs with a rating of 4.5 or above, the plans achieving this excellent quality score on the largest Medicaid membership base are Health Partners Plans in Pennsylvania, Neighborhood Health Plan of Rhode Island, and Priority Health in Michigan.
5-Slide Series
The December edition addresses some aspects of how quality data are reported and are used in performance-based payment structures.
5-Slide Series
This edition assesses the 2014 NCQA Medicaid MCO quality scores. Analysis includes calculation of statewide average scores for all plans, top performing MCOs relative to their state’s average, comparisons by ownership (such as publicly traded versus non-publicly traded MCOs), and trends for scores from 2013-2014.
Publication
This report assesses Medicaid MCO quality scores as published annually by NCQA. One of the report’s key findings is that there does not appear to be any relationship between Medicaid MCOs’ enrollment levels and their quality scores. Another is that high-scoring plans are disproportionately concentrated in certain states – with these patterns often recurring (with different health plans in these same states) with regard to quality scores in the Medicare and private insurance sectors. This leads us to conclude that some geographic areas are more conducive to high scores than others – and that MCOs making the same efforts in quality would likely obtain very different quality scores based on the market area in which they operate. Our report also identifies the Medicaid MCOs with both large enrollment and high quality scores, the MCOs that stand out most favorably relative to average scores within their state, and the NCQA-accredited MCOs achieving the greatest improvements in their quality scores between 2010 and 2013.
5-Slide Series
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.
5-Slide Series
This edition of the Series focuses on Medicaid MCO quality ratings, working with the data NCQA publishes each year. These slides calculate average quality scores in each of the 33 states with at least one NCQA-ranked plan. We also ranked the Medicaid MCOs by how their quality scores compares with the average of the other NCQA-ranked MCOs in their state.
