NCQA s Health Insurance Plan Rankings

Transcription

1 NCQA s Health Insurance Plan Rankings

2 Table of contents The main things to know (p. 3) What s the same as last year (p. 4) What s new this year (p. 7) How rankings will be displayed (p. 9) Schedule (p. 16) FAQs (p. 17) For more information & about next year (p. 19) 2

3 The main things to know 1. HMOs & PPOs get ranked together as one big list, as in past years 2. Consumer Reports will reprint the rankings online and in the November edition of their magazine (on sale late September) 3. Use the time between September 8 (when plans receive the rankings) and September 18 (when the public sees the rankings) to prepare promotional materials about your rankings results 4. Promoting your rankings results may begin at 6pm Eastern on September Promotions about the rankings must cite the rankings as NCQA s [Private/Medicare/Medicaid] Insurance Plan Rankings Promotions must not mention Consumer Reports 3

4 Most things are the same as past years NCQA will rank plans based on combined HEDIS, CAHPS and NCQA Accreditation standards scores NCQA will license the rankings data to Consumer Reports (CR) to publish online and in Consumer Reports magazine CR s No Commercial Use Policy bars health plans from mentioning Consumer Reports in promotional materials See: 4

5 Most things are the same as past years Private (Commercial) and Medicare rankings will include PPOs Private, Medicare and Medicaid rankings will be published at the same time Pre-approval by NCQA of press releases and marketing materials is not required 5

6 Ranking PPOs is the same as past years, too Private and Medicare only (Insufficient data for Medicaid) Same methodology as for HMO/POS plans PPO rankings are calculated with HMO/POS rankings to create combined rankings only Think one big mix / one rank / one number per plan 6

7 New this year Special Needs Plans (SNP) flag /footnote Medicare plans with 100% special needs members will be footnoted in rankings displays Judicious Resource Use Supplemental analysis by Consumer Reports See next slide 7

8 Supplemental analysis by Consumer Reports: Judicious Resource Use (JRU) Not part of rankings methodology (does not affect rank numbers) Acquaints Consumer Reports readers with topics related to value For Private HMOs & PPOs only Only in magazine and CR online magazine archive (not in interactive displays at CR online) Methodology will be posted online in late September 8

9 How rankings will be displayed Online NCQA Rankings Summary - Free - Selectable by product line (Private, Medicare, Medicaid) - Sortable by org name, type (HMO or PPO) - Sortable by NCQA Accreditation (Yes, No, Interim, Scheduled, In Process) Rankings Detail - Free - 1 page per plan Consumer Reports Private (Free) Medicare (Free) Medicaid (Free) Print NA Private, maybe Medicare: 1 national magazine and ipad edition 9

10 Rankings Summary on NCQA Web site (Shown: 2013 data & display) 10

11 Rankings Detail on NCQA Web site (Shown: 2013 data & display) 11

12 Consumer Reports magazine/online PDF: 1 national edition, HMOs and PPOs displayed together Sample shown is from In 2014, the circled section will show Judicious Resource Use results. 12

13 Consumer Reports online: Search view (2013 data) 13

14 Consumer Reports online: Compare view (2013 data) 14

15 Consumer Reports online: Report Card view (2013 data) 15

16 Schedule Communication Sent to Date Rankings Project Announcement HEDIS & Accreditation staff, Medical Director, CEO, Marketing Manager February 27 Data Confirmation HEDIS & Accreditation staff June 1 Accreditation Status, Projected Rank, Projected Score Notification Final Rankings Notification (all plans results) Final Rankings posted on NCQA.ORG (plans promotional embargo ends 6pm ET) Final Rankings printed in November issue of Consumer Reports (journalists embargo ends 6am ET) Final Rankings posted on CR Web site (journalists embargo ends 6am ET) HEDIS & Accreditation staff August 7 HEDIS & Accreditation staff, Medical Director, Marketing Manager Sept. 8 NA Sept. 18 NA NA Week of Sept. 22 Week of Sept

17 FAQ Page 1 of 2 Q: May plans communications about the rankings reference NCQA? A: Yes, they must, per NCQA s Marketing Guidelines: Q: May plans reference CR s role in the rankings by saying as seen in Consumer Reports? A: No, they must not, per CR s No Commercial Use policy: Q: What is the fee to view rankings on the CR Web site? A: Zero. All rankings information and functionality is free on the CR site. Q: May plans communications refer to rankings from , the years that NCQA produced rankings with USNews? A: Yes, as long as plans distinguish the rankings from subsequent rankings by using the official names and editions of all rankings. The rankings are called America s Best Health Insurance Plans [year]. 17

18 FAQ Page 2 of 2 Q: Will consumers be able to see rankings by plan type (PPOs only or HMOs/POS only)? A: Plan type will be a sortable field on NCQA s Rankings Detail page. Consumer Report magazine will show plans in rank order by state. The Consumer Reports Web site allows selection by plan type within a state, and also allows comparisons between plan types. Q: Will bulk orders of the Consumer Reports magazine be available? A: No, bulk copies and reprints are not available. However, Consumer Reports permits linking to its free online content, as long as the link is not surrounded by language promoting a specific product or service. Not acceptable: "Consumer Reports just rated us number one. Click here for the story. Acceptable: Neutral language such as, "Consumer Reports has an article on our product. Click here for more information. For more, visit: 18

19 NCQA For more information Methodology Overview Marketing Guidelines Badges that plans can use in marketing materials Individual questions Consumer Reports 19

20 Postscript: Change from Rankings to Ratings Next Year Current ( ) rankings methodology to be retired and replaced by ratings in ratings methodology available at In October 2014, NCQA will inform each plan what its 2014 result would have been using the 2015 ratings methodology Results are private, unofficial and not to be marketed 20