As large purchasers of healthcare, employers have a strong interest in the cost and quality of healthcare services their employees receive. Higher cost often does not indicate higher quality. Therefore, the NH Insurance Department provides the following tools to assist employers seeking quality information.
National Committee for Quality Assurance (NCQA) is a private, 501(c)(3) not-for-profit organization that measures clinical quality and member satisfaction for health insurance plans. NCQA provides voluntary accreditation for various health care providers and health insurance plans.
NCQA Health Plan Ratings
- Ratings are provided using a 0-5 scale in 0.5 increments.
- NCQA health insurance plan ratings are based on HEDIS, CAHPS, and results from NCQA Accreditation surveys.
- Health insurance plans are given an overall score which is broken down into specific categories related to consumer satisfaction, prevention, and treatment.
Review NCQA Summary Report for 2018-19
NCQA Accreditation Status & Stars
- Report cards scores are presented using a 1-4 star scale in whole-star increments.
- NCQA Report Cards are based on HEDIS, CAHPS, and accreditation scores.
- Accreditation scores are broken down into 5 categories (access and service, qualified providers, staying healthy, getting better, and living with illness).
Carrier Complaints
Confirmed individual and group fully insured complaint metrics per 1,000 enrollees compiled by the NH Insurance Department
Carrier Satisfaction Survey
Carrier information collected from consumer responses to Consumer Assessment of Healthcare Providers and Systems (CAHPS®) surveys. CAHPS surveys ask consumers to report on and evaluate their health care experiences. The surveys cover topics most important to consumers and focus on aspects of quality that consumers are best qualified to assess.