100% of NCQA 5.0 Rated and 96% of CMS 4.5 and 5-Star Health Insurance Plans Use Member Experience Solutions from SPH Analytics

October 27, 2021 David Oglesby

SPH solutions are a key contributor for nation’s top-performing health plans

ALPHARETTA, GA. (October 28, 2021) – According to a recently released Health Plans Rating 2021 Report from the National Committee for Quality Assurance (NCQA) and 2022 CMS Star Ratings Data, the nation’s top-performing health plans partner with SPH Analytics, a Press Ganey Solution for member experience measurement and engagement:

  • More than 94% of health plans with an NCQA 4.5 or 5 out of 5 rating 
  • 100% of Medicare and commercial plans with an NCQA 5 out of 5 rating
  • 96% of Medicare Advantage and Part D plans with CMS 4.5- and 5-Star Ratings.

“Despite unprecedented challenges amid the pandemic, health plans achieving the gold standard in quality performance demonstrated an unwavering commitment to consistently exceed member expectations and drive exceptional experience,” said Suzanne Cogan, general manager, SPH Analytics, a Press Ganey Solution. “We are proud to partner with top-performing organizations and unlock insights across the entire member journey that, in turn, power system-wide transformation.”  

SPH has administered the CAHPS® Survey since the program’s inception in 1998 and is an NCQA-certified Survey Vendor, as well as a CMS-Approved Medicare CAHPS Survey (MA & PDP CAHPS) Vendor. NCQA rates Commercial, Medicare, Medicaid and Exchange health plans based on their combined HEDIS®, CAHPS and NCQA Accreditation standards scores. Member satisfaction performance as measured in the CAHPS Survey represents 18.5% of commercial plan, 18.6% of Medicare plan and 16.5% of Medicaid plan respective NCQA ratings.

In addition to regulatory surveys, SPH helps health plans measurably improve the member experience through cutting-edge research, healthcare consumer experience solutions and integrated analytics. In fact, 100% of the nation’s top 64 largest plans partner with SPH to reduce member churn and improve Star Ratings.

To learn more about SPH Analytics, a Press Ganey Solution, and how to strategically engage member populations, visit PressGaney.com.

About SPH Analytics, a Press Ganey Solution 

SPH Analytics, a Press Ganey Solution, offers the leading healthcare measurement and analytics platform for health plan member experience and engagement. Leveraging a foundation of 35 years of healthcare consumer experience data and behavioral patterns, SPH deploys an analytical and predictive approach to measure and report the consumer experience, understand root causes to drive quality improvement and create blueprints for who, how, and when to engage consumers for optimal outcomes. 

As the top-ranked patient satisfaction measurement firm for health plans by Modern Healthcare, SPH is the recognized leader in the industry and the only company certified to conduct all CMS-and NCQA-mandated experience surveys. SPH serves health plan clients in all 50 states, reaches out to 92 million consumers annually, and aggregates data into proprietary benchmarks that represent 70%+ of the U.S. payer market.

About NCQA

The National Committee for Quality Assurance (NCQA) is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS® is the most widely used performance measurement tool in health care. NCQA’s website (www.ncqa.org) contains information to help consumers, employers and others make informed health care choices.

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ). HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).


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