Tufts Health Plan Receives Accreditation from National Committee for Quality Assurance for its Rhode Island Medicaid Plan

Evaluates the quality of health care that health plans provide to their members

August 18, 2020  

Providence, R.I. - Tufts Health Plan has been awarded an accreditation by the National Committee for Quality Assurance (NCQA) for its Medicaid HMO product in Rhode Island—recognized for its service and clinical quality through a rigorous evaluation of consumer protection and quality improvement requirements.

NCQA Accredited Health plan Badge

“This national accreditation underscores our commitment to make certain our Rhode Island members have quality health coverage, especially those who have high-risk health conditions,” said Tom Croswell, president and CEO for Tufts Health Plan. “I’m proud of our employees who make coordinating our members’ care a top priority, recognizing that the health care system can be both intricate and confusing. We want to be sure Rhode Islanders receive the greatest value from their health plan.”

The NCQA Health Plan Accreditation evaluates how well a health plan manages all parts of its delivery system—physicians, hospitals, other providers and administrative services. This national standard is set to represent the best practices in the insurance industry and continues to guide Tufts Health Plan’s approach to the services it provides to members, both in clinical and operational measures.

Tufts Health Plan began serving Rhode Islanders in 2009, offering employer-sponsored plans to expand upon its mission to improve the health and wellness of diverse communities. Since 2017, the health plan has provided Medicaid coverage for low-income Rhode Islanders, and now supports 23,000 members across employer-sponsored plans and Medicaid, with high-quality, affordable health care for themselves and their families.

Tufts Health Plan’s Massachusetts Medicaid plan is ranked as one of the top health plans nationally by NCQA, receiving a 4.5 rating. Only 14 other Medicaid plans received a 4.5 rating or better.1 Its commercial HMO/POS and Massachusetts PPO plans are rated 5 out of 5 – the highest rating possible – by the NCQA.2

About NCQA
NCQA is a private, nonprofit 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. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more-informed health care choices. NCQA can be found online at ncqa.org.

  1. NCQA’s Medicaid Health Insurance Plan Ratings 2019–2020
  2. NCQA’s Private Health Insurance Plan Ratings 2019-2020