Tufts Health Plan receives the highest rating possible for the quality of its health plans

WATERTOWN, Mass., Sept. 23, 2019 /PRNewswire/ — Tufts Health Plan today announced it is rated 5 out of 5 – the highest rating possible – by the National Committee for Quality Assurance (NCQA) on its annual 2019-2020 rating of private health insurance plans.* The rating includes several distinctions:

  • Only three other private health plans in the country earned a “5” rating, putting Tufts Health Plan in the top one percent of plans nationally;
  • It is the only health plan in the nation to receive the 5 out of 5 rating for both its HMO and PPO products;
  • It is the only plan in Massachusetts or Rhode Island to receive the rating of 5 out of 5 for its products;
  • And its Massachusetts PPO is the only PPO plan in the country to receive a 5 out of 5 rating.

Tufts Health Plan also announced its Massachusetts Medicaid plan achieved a 4.5 rating by the NCQA, placing it amongst the top health plans nationally. Only 14 other Medicaid plans received a 4.5 rating or better.**   

“We are committed to providing innovative coverage that is of the highest quality for our members,” said Tom Croswell, Tufts Health Plan president and CEO. “I am proud of the dedicated employees across our entire organization who work closely with the provider community to ensure our plans bring the best value to our members.”

The NCQA ratings, which rated 438 private commercial plans and 171 Medicaid plans, are based on quality measures from three performance subcategories—consumer experience, prevention, and treatment—and NCQA accreditation. This is the 15th consecutive year that Tufts Health Plan has been among the highest-rated private health insurance plans in the nation by NCQA and the 10th consecutive year that its Medicaid plan has been among the highest-rated plans by NCQA.

“Collaboration with the provider community is key to assuring that our members receive the coordinated care they deserve,” said Paul Kasuba, MD, Tufts Health Plan Chief Medical Officer. “The NCQA review process is very comprehensive, and once again we have demonstrated we are one of the best health plans in the country.”

This most recent distinction continues a tradition of quality for Tufts Health Plan dating back to 1997, when its HMO and POS plans first earned the highest accreditation possible by the NCQA.

About NCQA
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance.

About Tufts Health Plan
Celebrating our 40th anniversary in 2019, Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage.  Staying true to our mission of improving the health and wellness of the diverse communities we serve, we touch the lives of more than 1.16 million members in Massachusetts, Rhode Island, New Hampshire and Connecticut through employer-sponsored plans; Medicare; Medicaid and Marketplace plans, offering health insurance coverage across the life span regardless of age or circumstance. We are continually among the top health plans in the country based on quality and member satisfaction. Our Tufts Medicare Preferred HMO and Senior Care Options plans received a 5-star rating from the Centers for Medicare & Medicaid Services, the highest rating possible.*** Our commercial HMO/POS and Massachusetts PPO plans are rated 5 out of 5 – the highest rating possible – by the National Committee for Quality Assurance (NCQA).*

To learn more about how we’re redefining what a health plan can do, visit www.tuftshealthplan.com/whatwedo.  Connect with us on Facebook, Twitter, YouTube and LinkedIn

* NCQA’s Private Health Insurance Plan Ratings 2019–2020; Tufts Health Plan’s HMO/POS plan in Massachusetts and Rhode Island rated a 5 out of 5; Tufts Health Plan’s PPO plan in Massachusetts rated a 5 out of 5.

**NCQA’s Medicaid Health Insurance Plan Ratings 2019-2020.  This rating references Tufts Health Plan’s Massachusetts Medicaid plan.  Tufts Health Plan’s Rhode Island Medicaid plan has not yet been rated.

***Every year, Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov. Tufts Medicare Preferred HMO plans received 5 out of 5 stars for contract years 2016, 2017, 2018, 2019.***

Contact: Kathleen Makela


SOURCE Tufts Health Plan

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