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Compare health plan quality

Network quality

Most health plans have networks that have quality providers close to where you live. Use a plan’s provider directory to get an idea of whether or not the plan’s network meets your needs. To learn more, read Comparing Networks.

Plan quality comparison

You can check to see if a health plan is accredited by using the resources below. Accreditation means that another company has examined the plan and found that it meets certain quality measurements. The following lists some of the main accrediting companies. You can ask the plans you’re considering if they have any other accreditation.

NCQA Health Plan Report Card
The National Committee for Quality Assurance (NCQA) is a nonprofit organization that measures and accredits health plans. The Health Plan Report Card website lets you compare plans and see star ratings in five categories of quality. Each category lets you know, on average, the quality of care people receive in the plan. Depending on their scores, NCQA will label a plan as “excellent,” “commendable,” or “accredited,” or it will not accredit them at all.

URAC Directory
URAC is a nonprofit organization that measures and accredits health plans. URAC makes sure health plans meet standards of quality and operational integrity. Use the URAC directory to view a health plan’s accreditation status. To learn more about URAC’s accreditation, read its Health Plan Programs page.

Office of Public Insurance Counsel
The Office of Public Insurance Counsel (OPIC) is a Texas state agency that represents consumers. OPIC summarizes an extensive list of quality scores for HMOs. The scores measure patient experiences, such as care from doctors and ease in working with the HMO.

OPIC Resources: Comparing Texas HMOs | HMO Comparison by Company | HMO Comparison by Region

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Last updated: 10/30/2018