This year, NCQA has identified top-rated HMO and POS plans nationwide, but with many concentrated in the Northeast and on the West coast -- led by #1 ranked Harvard Pilgrim Health Care in Maine and Massachusetts, followed by Tufts Associated Health Maintenance Organization (#2) in Massachusetts, New Hampshire, and Rhode Island, and Harvard Pilgrim Health care of New England (#3).  

The rankings also find that many HMOs that submit to the voluntary ratings are owned by the major health insurance companies, including Aetna, Cigna, Humana, Kaiser Permanente, United Healthcare, and Wellpoint.  But, as Consumer Reports notes, plans with the same brand names can vary in quality, with some plans ranked high on the list and some ranked low.  The same goes for Blue Cross and Blue Shield plans, which are independently owned and operated but might be mistakenly construed as affiliated.  

"Consumers shouldn't enroll in a plan based on its brand name," said Findlay.   "We advise consumers to take a variety of factors into account, including these rankings.  Plans that are reporting to NCQA have made a commitment to quality improvement and public transparency.  As a result, we tend to think people should be skeptical of enrolling in a plan that is not on the NCQA list at all or has submitted its data but declined to have that data made public."   The report notes that while most of the 25 top-ranked individual HMOs are fairly large, some, like ConnectiCare in Massachusetts and Grand Valley Health Plan in Michigan, have fewer than 40,000 enrollees.

SOURCE Consumer Reports