Top Commercial Health Insurance Plans
Recently, U.S. News & World Report released findings on various types of health care plans throughout the United States. They surveyed members of commercial health plans, Medicare and Medicaid that operate throughout the country. The survey used criteria like customer satisfaction, physician ratings, prevention, and treatment.
According to U.S. News “…the 469 ranked plans received scores of 0 to 100 and overall ratings of 1 to 5 stars. Star ratings are also shown for individual measures, combinations of measures (such as ‘women’s reproductive health’), and the three major categories—prevention, treatment, and consumer assessment. An additional 94 plans did not provide enough data to be ranked but are listed with the information available.”
The following five health care plans are the top rated commercial plans according to this study. You’ll learn what geographic areas they cover, how they rated in terms of overall score and what makes it so darn wonderful to be a member of these plans.
Harvard Pilgrim Health Care
Serving the states of Massachusetts and Main, Harvard Pilgrim Health Care kicked the competition’s backside, taking the #1 ranked commercial health plan spot. They received a score of 91.2 across all of the criteria, and here is why. As car as Consumer Assessment, Harvard Pilgrim received an overall rating of 5 gold stars. Everything from customer service to claims processing to high ratings for physicians and specialists received nothing but the highest marks.
Areas that received three stars in this category, which would suggest areas for improvement, were things like getting care quickly and how well doctors communicate. Prevention, in every single area surveyed, got 5-star ratings. That’s incredibly impressive, considering that the more preventative measures you take, the healthier a person you are and the less you spend over time.
Treatment also received high marks across the board, with the only area receiving 2-3 stars versus the full 5 being appropriate antibiotic use in adults with acute bronchitis and medicating the 18-56 year old age set appropriately. If those few areas of two or three stars (which is still like a C-D or better rating if we want to get old school about it) are they only things that Harvard Pilgrim needs to work on, then their patients should consider themselves very lucky.
Tufts Associated Health Maintenance Organization
Tufts Associated Health Maintenance Organization (an HMO, obviously) serves the states of Massachusetts, New Hampshire, and Rhode Island. It ranked #2 in this gathering of data and surveying of patients, an scored an overall 91.2. What is interesting here is that they are ranked #2 yet have the same overall score as top ranked Harvard Pilgrim. Further investigation on the study and U.S. News’ websites didn’t uncover any explanation.
Moving on, what makes Tufts and their care so top notch? What really stands out is their ratings in Preventative care. Overall Prevention scored 5 stars, with the only weak area under this umbrella being 3 stars for women’s postpartum care. Other than that one 3-star rating, patients seem thrilled with Tufts preventative medicine from well-child visits to breast cancer and chlamydia screenings. Follow-ups across the board seemed to tank quite high, which indicates that this health care provider cares about their patients even after they walk out the door.
Harvard Pilgrim Health Care of New England
Just like their sister plan in Massachusetts, Harvard Pilgrim Health Care of New England is near the tip top of the list. This health plan serves the state of New Hampshire only, but received a terrific score of 90.6. Like Tufts before it, Harvard Pilgrim of New England takes the cake when it comes to Prevention. Women seem slightly dissatisfied with the prevention care when it comes to overall women’s reproductive health, timeliness of prenatal checkups and postpartum care. That said, these areas still received 4 stars. Every single other Prevention category ranked 5 stars. They really love heading off disease at the pass back East!
One poor statistic that jumped out at me (receiving one star) was appropriate antibiotic use in adults with acute bronchitis. One has to wonder why this scored so low among other great ratings. Was there a smaller data pool surveyed on this particular item? Was it just one person who had a terrible experience in this area? Or is their overall care in this area just very poor?
Grand Valley Health Plan
As a current resident of the state of Michigan, I’m happy to see one of the health plans in the state ranking so highly. Granted, my own health care plan didn’t make the list, but that’s another story. Grand Valley Health Plan serves the state of Michigan, and received a score of 89.1. Grand Valley excels when it comes to Treatment ratings. Some were marked “NA,” meaning that the benefit wasn’t offered or few members were affected. That said, there were 2 ratings which received ratings of 2 or 4 stars, but that is out 33 categories. The rest received high marks, with heart disease treatment really standing out above the others.
Geisinger Health Plan
Geisinger Health Plan, serving the residents of Pennsylvania and receiving a score of 88.2 is our fifth ranked commercial health plan. Geisinger is a standout when it comes to the care of children, infants and expectant mamas. There are two rankings where only 4 stars were rewarded, but otherwise patients seem incredibly satisfied with the care that is given to their kids, before, after and during birth. Postpartum care also ranks very highly in Geisinger, unlike some of the other higher ranked health care plans around the country. There no categories in which Geisinger received 1 or 2 stars, which speaks highly to their excellent service across the board.
The patients have spoken. One great thing about a study like this is that it is decided and voted upon by the people whose voice should be heard. If you were hearing statistics on health care plans from the doctors or insurance companies, everyone would be battling it out for the #1 slot. But because this study helps consumers understand exactly why people like their health care plan, finding a new one can become a much easier process.
photo credit: Brooks Elliott
Tags: health insurance rankings, health insurance ratings, top five, top health plans, us news and world report
