--- title: "Number of 5-Star Health Plans Increases by 64% in Latest NCQA Ratings" id: "news-news-fierce-healthcare-9888ada08e179f2862a1bb3f" canonical_url: "https://medichelpline.com/news/news-news-fierce-healthcare-9888ada08e179f2862a1bb3f" content_type: "medical_news_article" category: "Industry" source_name: "Fierce Healthcare" source_url: "https://www.fiercehealthcare.com/payers/ncqa-reports-number-5-star-health-plans-jumps-64-2026-ratings" published_at: "2026-09-21T00:52:24.277Z" license: "CC-BY-NC-4.0 / Informational Use" --- # Number of 5-Star Health Plans Increases by 64% in Latest NCQA Ratings ## Metadata & Source Attribution - **Canonical URL:** https://medichelpline.com/news/news-news-fierce-healthcare-9888ada08e179f2862a1bb3f - **Category:** [Industry](https://medichelpline.com/news/industry.md) - **Reporting Source:** Fierce Healthcare - **Original Source URL:** [Read Original Article](https://www.fiercehealthcare.com/payers/ncqa-reports-number-5-star-health-plans-jumps-64-2026-ratings) - **Published At:** 2026-09-21T00:52:24.277Z ## Executive Summary & Key Highlights - The National Committee for Quality Assurance (NCQA) reported a **64% increase** in the number of **5-star** health plans for 2026 compared to last year. - A total of **18 plans** achieved **5-star ratings**, including **nine commercial plans**, **five Medicare Advantage plans**, and **four Medicaid plans**. - Notable high-rated plans include UPMC Health Plan, Blue Cross and Blue Shield of Massachusetts, and Harvard Pilgrim Health Care. - The report indicated an overall improvement in health plan performance, especially in **behavioral health** and **chronic disease management**. - **89%** of Medicaid measures improved year-over-year, showing widespread quality enhancements across the market. - **Chronic disease management** saw progress, but there was a decline in **diabetic eye exam performance**, which requires further attention. ## In-Depth Reporting & Editorial Analysis ## NCQA Reports Significant Growth in Top-Rated Health Plans The National Committee for Quality Assurance (NCQA) recently published its 2026 health plan ratings, revealing a striking **64% increase** in the number of health plans awarded a **5-star rating** from the previous year. This data highlights a growing trend toward enhanced quality within the healthcare system. A total of **18 health plans** earned the top **5-star rating**, which includes **nine commercial plans**, **five Medicare Advantage plans**, and **four Medicaid plans**. Noteworthy organizations achieving this designation include UPMC Health Plan, Blue Cross and Blue Shield of Massachusetts, and Harvard Pilgrim Health Care, among several **Kaiser Foundation Health Plans**. In addition, **53 plans** received a **4.5-star rating**, indicating a substantial rise in overall quality. ## Importance of NCQA Ratings The NCQA's annual ratings are crucial for both consumers and regulators, as they provide measurable benchmarks for assessing the quality and effectiveness of various health plans. Dr. Vivek Garg, president and CEO of NCQA, emphasized the significance of this year’s findings, stating, "The progress reflected in this year’s Health Plan Ratings is encouraging because it demonstrates meaningful improvement in the areas that matter most to patients, such as **behavioral health** and **chronic disease management**." By making performance visible, NCQA aims to foster accountability, enhance improvement efforts, and empower patients in their healthcare choices. ## Broader Trends in Healthcare Quality The 2026 ratings reveal that the average quality scores across health plans have increased, with decreasing variation between top and bottom performers. This suggests that the strategies for quality improvement have gained traction, becoming more effective and widely integrated throughout the healthcare sector. Such advancements could imply that quality enhancement methods are becoming standard practice among health plans. ### Focus on Behavioral Health and Chronic Disease Management One of the most promising areas of improvement identified in the NCQA report is **behavioral health**. The rise in quality can be attributed to increased investments in mental health services, care coordination, and vigilant follow-up care after hospitalization. Specifically, the report highlights substantial advancements in follow-up care for mental illness across commercial plans, Medicaid, and Medicare Advantage plans. Additionally, progress in chronic disease management has been notable, with performance improvements on nearly **80% of relevant measures**. Among these, **Medicare Advantage plans** showed significant enhancements in kidney health evaluations for patients with diabetes, with performance rising by **7.3 percentage points**. ### Areas Needing Improvement Despite these strides, there remain areas requiring focus and improvement. For instance, while chronic care performance overall has improved, there was a noticeable decline in **diabetic eye exam performance**. This decline underscores the need for stronger preventive care measures in chronic disease management. The NCQA indicated that while average benchmark performance improved across various plan types, the gains were consistent, ranging from **1.6 to 1.8 percentage points** across commercial, Medicaid, and Medicare Advantage plans. Particularly, Medicaid showcased the most extensive progress, with **89% of measures** improving from the previous year. ### Methodology Behind the Ratings The methodologies employed in the NCQA ratings involve a comprehensive evaluation of clinical quality, patient experience, and health plan structure and processes. The assessment utilizes data from numerous sources, including HEDIS and the Centers for Medicare & Medicaid Services’ Health Outcomes Surveys, as well as surveys from the Consumer Assessment of Healthcare Providers and Systems and NCQA’s Health Plan Accreditation. Health plans are rated on a scale from **0 to 5 stars**, allowing for comparative analysis of performance. ## Conclusion As the landscape of healthcare continues to evolve, the NCQA's report serves as essential guidance for consumers looking to make informed choices regarding their health plans. The marked improvements in health plan quality illustrate the effectiveness of strategic investments and a collective focus on elevating patient care standards. With this upward trend, even greater strides in overall healthcare quality may soon be anticipated. ## Navigation - [← Back to Industry News](https://medichelpline.com/news/industry.md) - [← All Medical News Categories](https://medichelpline.com/news.md) ## Medical & Regulatory Disclaimer > [!CAUTION] > MedicHelpline content is structured for research, educational, and professional discovery purposes. It does not constitute individual medical advice, clinical diagnosis, or treatment recommendations. > Always verify dosing, contraindications, and regulatory alerts against official product labeling and primary regulatory sources before clinical decision-making.