Tufts Health Plan Receives the Highest Rating Possible - ‘5’ out of ‘5’ - from the National Committee for Quality Assurance for its Private HMO and PPO Plans

Only three other plans in the country received a rating of “5”

September 20, 2017  

Watertown, MA – 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 rating of private health insurance plans.1 It is the only health plan in the nation to receive the 5 out of 5 rating for both its HMO and PPO products.1 Only three other plans in the country, from a pool of nearly 500 -earned a rating of “5.” 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 NCQA, placing it amongst the top health plans nationally.2 Only 10 Medicaid plans received a 4.5 rating, out of the nearly 300 evaluated.    

“It takes a significant commitment to be awarded the highest quality ratings from the NCQA,” said Tom Croswell, Tufts Health Plan president and CEO. “I am extremely proud of the hard work performed across our entire organization and the discipline from every Tufts Health Plan employee, as well as our collaborative provider community, to ensure our plans offer high value to our members.”

The NCQA ratings, which rate close to 500 private commercial plans and 200 Medicaid plans, are based on quality measures from three performance subcategories—consumer experience, prevention, and treatment—and NCQA accreditation. 

"We continue to work closely with the provider community to ensure that our members receive quality, coordinated care,” said Paul Kasuba, MD, Tufts Health Plan chief medical officer. “Our dedication to our members is evident in our success as we strive to deliver quality coverage year after year. Once again we have proven we are one of the best health plans in the country.” 

This is the 13th consecutive year that Tufts Health Plan has been among the highest-rated private health insurance plans in the nation by NCQA and the 8th consecutive year that its Medicaid plan has been among the highest-rated plans by 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. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. 

  1. NCQA’s Private Health Insurance Plan Ratings 2017–2018; Tufts Health Plan’s HMO/POS plan rated a 5 out of 5; Tufts Health Plan’s PPO plan in Massachusetts rated a 5 out of 5. Tufts Health Plan’s PPO plan in Rhode Island rated a 4 out of 5.
  2. NCQA’s Medicaid Health Insurance Plan Ratings 2017–2018.  This rating references Tufts Health Plan’s Massachusetts Medicaid plan.  Tufts Health Plan’s Rhode Island Medicaid plan has not yet been rated.