RENO — Saint Mary’s HealthFirst HMO/POS has been recognized as the number one plan in Nevada — and was nationally ranked 279th — in the National Committee for Quality Assurance (NCQA) Private Health Insurance Plan Rankings 2012-13. NCQA evaluated more than 538 private health plans, and of those, 474 were ranked.
Plans are given an overall score of 1 to 100 based on dozens of criteria, including consumer satisfaction, prevention, treatment and NCQA accreditation. Saint Mary’s HealthFirst HMO/POS earned an overall score of 81.4, up from 78.6 in 2011-12. The plan scored highest in prevention and treatment, specifically with women’s reproductive health, cancer screenings, heart disease and selected diabetes measures. Collectively, these efforts helped improve Saint Mary’s HealthFirst HMO/POS plan’s national ranking by 12 points, from 291st in 2011-12 to 279th in 2012-13.
Consumer satisfaction measures patient feedback about their care, including access and customer service. Prevention looks at how many members received preventive services such as prenatal and post-partum care, cancer screenings, immunizations and well-check visits for kids. Treatment measures how many members received the recommended care for their conditions. Accreditation is an independent review of how well a plan works with doctors and patients to provide high-quality care and provide important consumer protections. A plan can earn up to 15 points for being accredited, while non-accredited plans receive zero points in that category.