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Top Medicare Plans by State

Top Medicare Plans by State

The National Committee for Quality Assurance (NCQA) measured over 1,300 Medicare insurance plans for the year 2015-2016. Metrics measured were Consumer Satisfaction, Prevention, and Treatment, with sub-categories for each metric. Additionally, NCQA looked at clinical quality, member satisfaction, and NCQA Accreditation Survey results. NCQA used a half-point system to award scores from 1 through 5 points for each metric, much like Medicare’s own CMS ratings.

Based on NCQA’s findings, the Capital Health Plan in Florida, Group Health Plan (Cost) in Minnesota and Wisconsin, and Gundersen Health Plan in Iowa and Wisconsin ranked as the highest-performing plans.

The Categories

The first category NCQA measured was Consumer Satisfaction, in which surveyed members gave their opinions regarding their plan’s care, services, and physicians. Next, NCQA looked at Prevention. This indicates how each plan performed in providing screenings, immunizations, and other preventive services. Finally, the Treatment metric reveals how well plans performed treating both chronic and acute conditions.

Florida’s Capital Health Plan

The top-rated Medicare plan is Florida’s Capital Health Plan (CHP). The plan’s consumers view their coverage very positively, giving CHP a perfect rating for both ease of getting care and satisfaction with their health plan services. They also rated their physicians as 4.5 out of 5, with perfect scores given to their primary care doctors and their overall care.

Preventive care measures, assigned by NCQA rather than patients, received a 4.5 overall rating, with full marks given to breast and colorectal cancer screenings. Flu/pneumonia shots and adult BMI assessment each rated a 4. Under Treatment metrics, CHP received full marks once again for mental and behavioral health, and nearly perfect scores for diabetes treatment, with 4 points awarded for blood pressure control in diabetes patients. In heart disease and other treatment measures, CHP scores dipped slightly, but not enough to lower the overall Treatment rating of 4.0.

Capital Health Plan attributes these ratings, the highest not only in Florida but also across the nation, to its member-focused approach and evidence-based treatment practices.

Group Health Plan in Minnesota and Wisconsin

Members of the Group Health Plan (GHP) in Minnesota and Wisconsin rated their Medicare plan 4.5 out of 5 possible points, awarding full points to how quickly they received care, the level of care received, and their plan overall.

NCQA awarded GHP 4.5 points for Prevention, with perfect marks for colorectal cancer screening, flu shots, and pneumonia shots. It also gave the provider a perfect score in diabetes treatment, treating depression, and osteoporosis testing, to go along with a 4.5 for heart disease.

Gundersen Health Plan in Iowa and Wisconsin

Judging by the ratings, Gundersen Health Plan (GHP) participants in Iowa and Wisconsin love their Medicare provider, awarding perfect marks in six out of seven metrics, including ease of receiving care, specialists, and overall health plan. The seventh metric, rating of primary care doctor, received 4 points.

NCQA also awarded GHP top marks for cancer screening and pneumonia shots under the Prevention metric. Additionally, diabetes treatment, controlling blood pressure, and COPD treatments all received perfect scores.


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