Tufts Health Plan is Ranked Third in the Nation for HMO and POS Plans
by the National Committee for Quality Assurance
U.S. News & World Report

We are pleased to announce that Tufts Health Plan has been named third in the country for its commercial HMO/POS combined product, based on criteria that measured clinical performance and member satisfaction among 239 of the nation’s commercial health insurance plans. This is the fifth year that Tufts Health Plan has been ranked among the top health plans by U.S. News & World Report and the National Committee for Quality Assurance (NCQA), which also ranked Tufts Health Plan Medicare Preferred, the company’s HMO Medicare Advantage offering, as fourth in the nation.

Since 1999, those products also achieved “Excellent” accreditation status from NCQA, the highest possible achievement for consumer protection, quality improvement and clinical effectiveness.

The announcement of plan rankings, part of the annual, in-depth “America’s Best Health Insurance Plans 2009-10” feature article released today, illustrates the commitment of Tufts Health Plan to improving quality and member satisfaction.  The federal agency for Healthcare Research and Quality defines quality health care as doing the right thing at the right time for the right person, and having the best possible result.  Tufts Health Plan’s performance across the spectrum of measures used to rank the nation’s health plans exemplifies these qualities and reflects the excellence of care delivered by our physicians and hospitals.

Tufts Health Plan proactively reached out to more than 300,000 members for preventive screening, disease management, and behavior health, an increase of 100,000 members from the previous year.  Additionally, Tufts Health plan continued to grow its membership and expanded its service area to Rhode Island, making it the highest ranked health plan in that state by NCQA.  Moreover, the organization maintained a fiscal discipline that kept its administrative costs in check while achieving its ongoing quality improvement effort and high degree of member satisfaction.

America’s Best Health Insurance Plans rankings are based on prevention, treatment and customer experience scores on a range of measures that health plans voluntarily report to NCQA. These scores are compiled in NCQA’s Quality Compass database.

Some areas of note within the HMO/POS findings include:

Pediatric Care

• adolescent well visits and primary care access for children seven to 11 years
• children aged three to six in receiving annual well visits and for children in the first 15 months receiving six or more well visits

Mental Health Access

• initiating care for children with attention deficit and for continued care for these children.

Medicare Advantage
Out of 166 plans, Tufts Health Plan’s Medicare Advantage HMO improved in its performance from last year’s 10th place ranking to 4th place ranking in the nation.  Among the 29 preventive and disease monitoring measures reviewed by the NCQA, 21 improved from the previous year, and 16 of these measures exceed the NCQA 90th percentile according to the 2008 Means and Percentiles benchmarks.  Moreover, the program performed significantly above the national average for ensuring seniors received flu shots, and vaccines.

National Committee for Quality Assurance
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations, recognizes physicians and physician groups in key clinical areas. NCQA is committed to providing health care quality information in order to help consumers, employers and others make more informed health care choices.

The NCQA accreditation survey process includes on-site and off-site evaluations of more than 60 standards and selected HEDIS® performance measures conducted by a team of physicians and managed care experts.  A committee of physicians analyzes the team’s finding and assigns an accreditation level based on the performance level of the plan being evaluated to NCQA’s standards.

Tufts Health Plan
Headquartered in Massachusetts, Tufts Health Plan, a not-for-profit organization, is nationally recognized for its commitment to providing innovative, high-quality health care coverage to its members.  The plan supports its members and employers with an array of physician led health management programs that use evidence-based medicine to design coverage that supports proven approaches to providing care and improving quality.  Tufts Health Plan’s HMO and POS are ranked third in the nation and its Medicare Advantage program is ranked fourth in the nation by the National Committee for Quality Assurance (NCQA).  Since 1999, those products also achieved Excellent accreditation status from NCQA, the highest possible achievement for consumer protection, quality improvement and clinical effectiveness.  More information about the organization is available on its Web site www.tuftshealthplan.com


** America’s Best Health Insurance Plans is a trademark of U.S. News & World Report.
HEDIS is a registered trademark of NCQA.