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Buffalo’s nonprofit health insurers perform well in quality ratings

The three major insurers that serve the Buffalo market received generally high ratings in the latest annual assessment of health insurance companies by the National Committee for Quality Assurance.

The committee rated 1,016 plans nationwide for 2015-16 in three broad categories — consumer satisfaction, prevention and treatment — from one to five, with five indicating the highest performance.

The factors used to produce the ratings included what members said in satisfaction surveys about their plans’ customer service; the types of wellness checkups and tests offered to patients; and whether a plan routinely provides recommended care for common, expensive ailments such as diabetes, depression and heart disease.

The committee rated the insurers’ private plans, their Medicare plans – which serve senior citizens and the disabled – and their Medicaid plans, which serve people with low incomes. Nationwide, across all product lines, the average rating was a 3.5.

Locally, for the private plans, Buffalo-based Health Now New York, which operates locally as BlueCross BlueShield of Western New York, received 4.5 out of five.

“The most recent NCQA rankings reflect that our commitment to quality, even in the midst of implementing ACA mandates, will not waver,” Julie Snyder, a HealthNow spokeswoman, said in a statement, referring to the Affordable Care Act.

Independent Health of Amherst also received a 4.5 rating for its health maintenance organization, or HMO, and its point of service, or POS, plans, while the committee reported partial data for Independent Health’s preferred provider organization, or PPO.

“The NCQA ratings serve as a valuable tool for consumers to assess plan performance,” Dr. Michael W. Cropp, president and CEO of Independent Health, said in a statement.

Univera Healthcare of Amherst, part of Rochester’s Excellus BlueCross BlueShield, earned a rating of 4.0.

For the insurers’ Medicare plans, HealthNow’s HMO and PPO both earned 4.5; Independent Health’s HMO earned 4.5 and its PPO, which enrolls far fewer members, earned 3.5; and Univera’s HMO earned 4.5 while the company does not have a Medicare PPO plan.

“Our star ratings are similar to other upstate plans, which reinforces the value of nonprofit plans since nonprofit plans scored higher than most for-profit plans,” Peter Kates, a Univera spokesman, said in an email.

And for their Medicaid plans, HealthNow received a 4.0 rating and Independent Health received 4.0 for its Medicaid HMO plan. A plan operated in partnership by Univera Healthcare and Monroe Plan of Rochester, Univera Community Health, received a 3.0 rating from the committee. Univera Healthcare has since withdrawn from the partnership, and Monroe Plan has changed the name of the plan to YourCare Health Plan.

The National Committee for Quality Assurance has changed from the ranking system it previously published each fall, in partnership with U.S. News & World Report and Consumer Reports, to a rating plan that closely follows the star-rating system used by the federal Centers for Medicare and Medicaid Services to evaluate Medicare Advantage plans.

The committee is continuing to work with Consumer Reports, which will mention the ratings on its website and in the November edition of its magazine. For more information, go to ncqa.org/ratings.

email: swatson@buffnews.com