Christine Jordan Sexton
Molina Healthcare of Florida is the top-rated Medicaid HMO in the state, earning four stars on the National Committee on Quality Assurance’s “report cards” released Wednesday.
Conversely, Vivida Health and Magellan Complete Care earned the lowest scores on the report card, at just two-and-a-half stars out of a possible five. The two provide Medicaid-managed care plans in Florida.
NCQA evaluates health plans on the quality of care patients receive, how happy patients are with their care, and health plans’ efforts to keep improving.
It is the first report card that the National Committee for Quality Assurance has released since 2019. NCQA canceled the 2020 report card because of the pandemic. In determining its scores the NCQA rated health plans in three broad areas: patient satisfaction; prevention and treatment.
Specifically, NCQA assigns stars based on the combined Consumer Assessment of Healthcare Providers and Systems, or CAHPS, HEDIS, or health care effectiveness data and information set, scores. It also takes into consideration its NCQA accreditation scores.
Tallahassee-based Capital Health Plan was the top-ranked commercial HMO as well as the top-ranked Medicare HMO, earning four-and-a-half stars for both HMO offerings.
No managed care plan in the state earned a five-star rating, the highest NCQA award, regardless of whether the plan served Medicaid clients, Medicare clients or commercial clients. Conversely, no managed care plan operating in Florida earned one or two stars.
Two-and-a-half stars was the lowest score delivered on the 2021 report card.
The Agency for Health Care Administration, which houses the state’s Medicaid office and is charged with administrative oversight of the contracts for the 11 Medicaid Regions, did not comment on the Medicaid HMOs’ performances at press time.
Molina has contracts with the state Agency for Health Care Administration to provide health care services to beneficiaries in Medicaid Regions 8 and 11. As of Aug. 31, 118,720 Medicaid enrollees were enrolled in the plan, according to state data.
Medicaid Region 8 consists of Charlotte, Collier, Desoto, Glades, Hendry, Lee and Sarasota counties. Medicaid Region 11 covers Miami-Dade and Monroe counties.
Vivida Health operates only in Medicaid Region 8, and had 21,550 members at the end of August.
Magellan Complete Care, which offers a specialty health plan for people with serious mental health illnesses, operates in three Medicaid Regions: 4,5 and 7, and had 25,210 enrolled at the end of August. Medicaid Region 4 includes Baker, Clay, Duval, Flagler, Nassau, St. Johns and Volusia counties. Region 5 includes Pasco and Pinellas counties and Region 7 includes Brevard, Orange, Osceola and Seminole counties.
