Health Plan Performance Ratings

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Health Plan Star Rating Systems

When choosing a Medicaid plan, it's important to compare health plan performance and star rating systems. 

  • Every September, the National Committee for Quality Assurance (NCQA) rates more than 1,000 health insurance companies.
  • NCQA uses evidence-based measurement and specifications to benchmark health plan performance.
  • For more information, see NCQA Health Plan Ratings.
Health Plan Ratings
Rating metricWellpoint (WLP)Iowa Total Care (ITC)Molina (MOL)
Stars (overall)4/5 stars3.5/5 starsNot star rated yet.
Patient experience3.02.5N/A
Prevention & equity3.53.0N/A
Treatment3.53.5N/A
Distinction(s)Health Plan Accreditation
Health Equity Accreditation Plus
LTSS		Health Plan Accreditation
Health Equity Accreditation Plus
LTSS		Health Plan Accreditation
Health Equity Accreditation Plus
LTSS
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Compare Health Plan Performance Measures

  • Compare plans based on how well they perform at measures that matter most to you and your family.
  • + marks indicate plans performed at or better than national HEDIS average.
  • o marks indicate plans performed below the national HEDIS average.
Performance measures
MeasureWLPITCMOL
Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)++n/a
Initiation of Substance Use Disorder Treatment (IET)++n/a
Engagement of Substance Use Disorder Treatment (IET)++n/a
Depression Screening and Follow-Up for Adolescents and Adults (DSF-E) (note: Was not required by NCQA in MY2023)n/an/an/a
Follow-Up After Hospitalization for Mental Illness (FUH) (7 days)++o
Follow-Up After Hospitalization for Mental Illness (FUH) (30 days)++o
Well-Child Visits in the First 30 Months of Life (W30) (First 15 months)++n/a
Well-Child Visits in the First 30 Months of Life (W30) (15-30 months)++n/a
Child and Adolescent Well-Care Visits (WCV)++n/a
Breast Cancer Screening (BCS-E)++n/a
Cervical Cancer Screening (CCS, CCS-E)++n/a
Colorectal Cancer Screening (COL-E)++n/a
Prenatal and Postpartum Care (PPC) (Timeliness of care)+++
Prenatal and Postpartum Care (PPC) (Postpartum care)+++
Glycemic Status Assessment for Patients with Diabetes (GSD) HbA1c Control (<8.0%)oon/a
Glycemic Status Assessment for Patients with Diabetes (GSD) Poor HbA1c Control (>9.0%)++n/a
Asthma Medication Ratio (AMR) +on/a
Controlling High Blood Pressure (CBP)++ n/a

Iowa Medicaid uses nationally recognized HEDIS measures (Healthcare Effectiveness Data and Information Set) to compare each health plan against other participating HMO Medicaid plans nationwide. Published results are based on Measurement Year (MY) 2023. Additional measures, years, and measure descriptions are available on the Iowa Medicaid Dashboard under "Quality Scores".

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Compare Health Plan Annual Member Surveys

  • Compare plans based on how well they perform at measures that matter most to you and your family.
  • + marks indicate plans performed at or better than national CAHPS average.
  • o marks indicate plans performed below the national CAHPS  average.
Performance measures
MeasureWLPITCMOL
How people rated their health plan - Children++o
How people rated their health plan - Adultsooo
Getting care quickly - Children+++
Getting care quickly - Adultso++
Getting needed care - Children+++
Getting needed care - Adults+o+
How well doctors communicate - Children+++
How well doctors communicate - Adults+++
Health plan customer service - Childrenn/a++
Health plan customer service - Adults+o+

Iowa Medicaid uses nationally recognized CAHPS Survey measures (Consumer Assessment of Healthcare Providers and Systems) to compare each health plan against other participating Medicaid plans nationwide. Published results are based on Measurement Year (MY) 2023. Additional surveys questions and survey years are available on the Iowa Medicaid Dashboard under "Quality Scores".

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