The National Committee for Quality Assurance has once again named the highest-quality and most effective health plans in the country, with Blue Cross Blue Shield of Massachusetts remaining at the top.
On Sept. 16, the NCQA released its 2025 ratings based on nearly 50 factors, including patient experience and clinical performance. The ratings incorporate HEDIS and CAHPS results from commercial, Medicare, Medicaid and ACA plans covering more than 227 million people. Plans were scored on a zero- to five-star scale, with five being the highest. Out of 998 plans that received a rating, just a handful achieved the top score.
For the second year in a row, BCBS Massachusetts’ PPO plan earned a five-star rating, placing it in the top 1% of commercial health plans nationwide.
Mark Friedberg, MD, senior vice president of performance measurement and improvement at the company, told Becker’s the achievement reflects two core strategies: building strong provider relationships and directly engaging with members.
“The first [ingredient] is to maintain excellent relationships with our provider network in the state and to have contracts that have financial incentives in them that create a strong business case for our provider partners to invest in quality improvement efforts,” Dr. Friedberg said. “That seems to have really been panning out quite well over the last couple of years.”
“We actually have internal teams of people who directly contact our members to encourage them to get cancer screenings, chronic disease management services and other guideline-important services that are measured in two-way ratings,” he added.
Despite more plans earning five stars this year than last, the vast majority of commercial health plans still fall short. Maintaining those top marks is only getting harder, Dr. Friedberg noted.
CAHPS survey results, which capture member experience, declined industrywide in the last year. At the same time, the NCQA is phasing out a hybrid claims-based method for some HEDIS measures, requiring health plans to review medical records for every member.
“That’s a big challenge, because we just don’t have great data transmission from providers to health plans at scale yet,” Dr. Friedberg said. “That’s something many plans struggle with, but it’s something we’re working with our provider network on. I think it’s all to the members’ benefit for us to be sharing information bi-directionally.”
Looking ahead, BCBS Massachusetts is focused on bringing its commercial HMO plan (which earned 4.5 stars in 2025) up to five stars while sustaining the PPO performance.
“The big areas of opportunity for us are to try to get our HMO to five stars to match our PPO, repeat the five-star performance, and focus on our CAHPS scores and our transition to ECDS HEDIS measure rates,” Dr. Friedberg said.
