PROVIDENCE, R.I., Aug. 18, 2020 /PRNewswire/ -- 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.
"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, on Twitter, on Facebook and on LinkedIn.
About Tufts Health Plan
Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage. Staying true to our mission of improving the health and wellness of the diverse communities we serve, we touch the lives of 1.15 million members in Massachusetts, Rhode Island, New Hampshire and Connecticut through employer-sponsored plans, Medicare, Medicaid and marketplace plans, offering health insurance coverage across the life span regardless of age or circumstance. We are continually among the top health plans in the country based on quality and member satisfaction. Our Tufts Medicare Preferred HMO and Senior Care Options plans received a 5-star rating from the Centers for Medicare & Medicaid Services, the highest rating possible.* Our commercial HMO/POS and Massachusetts PPO plans are rated 5 out of 5 – the highest rating possible – by the National Committee for Quality Assurance (NCQA).** Our Medicaid plan is rated 4.5 out of a possible 5.***
To learn more about how we're redefining what a health plan can do, visit www.tuftshealthplan.com/whatwedo. Connect with us on Facebook, Twitter, YouTube, LinkedIn and Instagram.
*Every year, Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next. For more information on plan ratings, go to www.medicare.gov. Tufts Medicare Preferred HMO plans received 5 out of 5 stars for contract years 2016, 2017, 2018, 2019, 2020.
**NCQA's Private Health Insurance Plan Ratings 2019–2020
***NCQA's Medicaid Health Insurance Plan Ratings 2019-2020
1 NCQA's Medicaid Health Insurance Plan Ratings 2019–2020
2 NCQA's Private Health Insurance Plan Ratings 2019-2020
Contact: Kathleen Makela
[email protected]
857-304-8293
SOURCE Tufts Health Plan
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