Harvard Pilgrim Health Care rated 5 out of 5 by NCQA for private HMO/POS and PPO plans

Sep 25, 2015
Harvard Pilgrim Health Care logoWellesley, MA (September 25, 2015) - Harvard Pilgrim was rated a 5 out of 5 for its private HMO/POS and PPO Plans by the National Committee for Quality Assurance on its annual rating of private health plans. Harvard Pilgrim Health Care of New England, Harvard Pilgrim’s New Hampshire affiliate, was rated 4.5 out of 5 for its private HMO/POS plans.**

The ratings are based on measures of clinical quality and member satisfaction. Specifically, clinical quality is measured by The Healthcare Effectiveness Data and Information Set (HEDIS)®, a tool developed by NCQA to enable purchasers and consumers to make reliable comparisons of health care plan performance. Other measures used to score health plans for NCQA’s rankings include the U.S. Agency for Healthcare Research and Quality’s (AHRQ) Consumer Assessment of Healthcare Providers and Systems (CAHPS) and NCQA’s accreditation standards ratings.

“This rating continues our history of being one of the highest-ranked private health plans in America,” said Eric H. Schultz, president and CEO of Harvard Pilgrim Health Care. “Thanks to strong partnerships with our doctors, hospitals, employers, brokers and, of course, our employees, we have successfully delivered on this promise and will continue setting the bar high for our members,” he said. “In addition, we want to empower members to make the best health care decisions for themselves and their families by making cost and quality information more accessible.”

"As our healthcare delivery system continues to evolve rapidly, the emergence of new types of provider partnerships to improve patient care will call for even closer collaboration between payor and provider,” said Michael Sherman, MD, chief medical officer. “To be successful, maintaining our focus on quality must continue to be of the utmost importance. NCQA's recognition provides objective evidence that these efforts really do make a difference with respect to the care and services that our members receive."

Harvard Pilgrim builds upon the solid relationships it has established with doctors and hospitals throughout the years by rewarding innovation and excellence with pay-for-performance, quality grants and physician and hospital honor roll programs. Both parties bring their respective strengths to the table to do what’s best for their members/patients, while addressing health care affordability and the total cost of care.

About National Committee for Quality Assurance
National Committee for Quality Assurance (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 in key clinical areas. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s Web site (www.ncqa.org) contains information to help consumers, employers and others make more informed health care choices.

About Harvard Pilgrim Health Care
Harvard Pilgrim Health Care is a not-for-profit health services company serving more than one million members in New England. Founded in 1969, the health plan has built its reputation on pragmatic innovation with a goal of lowering costs, improving care and enhancing the overall member experience. Harvard Pilgrim is known for its excellent clinical programs, customer service, health improvement strategies and innovative tools that offer consumers greater transparency and empower them to make better decisions about their health care.

Consistently ranked among America’s highest-rated private health plans*, Harvard Pilgrim Health Care has been rated 5 out of 5 for its private HMO/POS and PPO plans in the National Committee for Quality Assurance (NCQA) Private Health Insurance Plan Ratings 2015-2016. Harvard Pilgrim Health Care of New England has been rated 4.5 out of 5 for its private HMO/POS plans.**

* NCQA’s Private Health Insurance Plan Rankings, 2011-15, HMO/POS/PPO.
**NCQA’s Private Health Insurance Plan Ratings 2015-16

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Contact: 

Mary Wallan
(617) 509-2419
mary_wallan@hphci.org