South San Francisco, CA (September 17, 2024) – In their annual Medicaid Health Plan Ratings report, the National Committee for Quality Assurance (NCQA) awarded HPSM’s Medicaid (Medi-Cal) line of business 4.5 out of 5 stars. This represents an improvement of half a star for HPSM since 2023, when NCQA named HPSM one of California's top-rated Medicaid Plans.
NCQA accreditation is the healthcare industry’s “seal of approval,” indicating that HPSM meets the highest quality standards. 4.5 out of 5 stars is the highest rating any Medicaid (Medi-Cal) plan achieved this year. NCQA calculates Health Plan ratings using each plan’s comparative performance on a number of quality of care and member experience metrics and accreditation status. Out of 201 plans with a numeric rating, only 14 earned a 4.5 out of 5 star rating. This is further recognition that HPSM’s service and clinical quality meets or exceeds rigorous requirements for consumer protection and quality improvement.
HPSM CEO Patrick Curran said that “Being one of the highest-rated Medicaid plans in the nation demonstrates our commitment to continuous quality improvement. Achieving high ratings across many categories of patient experience, prevention, equity and treatment helps ensure our members have access to high-quality health care in our community.”
Each year, NCQA rates more than 1,000 health plans in all 50 states, U.S. territories and the District of Columbia. The results are then posted to NCQA’s Health Plan Report Cards website to help consumers, employers and others better understand the quality of care health plans provide to their members. HPSM-specific results are posted on the NCQA website.
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.
Health Plan of San Mateo (HPSM) is a local, non-profit County Organized Health System (COHS) founded in 1987. HPSM’s mission is to ensure that San Mateo County’s vulnerable and underserved residents have access to high-quality care, services and supports so they can live the healthiest lives possible. With more than 155,000 members or participants, HPSM serves all of the County’s Medi-Cal eligible residents, nearly 9,000 members eligible for both Medicare and Medi-Cal, as well as families, seniors, people with disabilities and children with complex medical conditions. HPSM also sponsors special programs that address the complex social issues that some eligible members face – from home-based health care to affordable housing for the homeless. Learn more at www.hpsm.org.