America's 20 best health plans

By U.S. News & World Report

Millions of American families need a hand as they sort through their health care options during this year's open-enrollment season, which involves much more than checking for the lowest premiums and out-of-pocket costs.

Saving money is a false economy if a health plan falls down on the job of providing good care and making it easy to get.

So for the fourth year, U.S. News, in cooperation with the National Committee for Quality Assurance, managed care's premier accrediting and standards-setting body, analyzed hundreds of health plans and ranked them by their performance in dozens of measures.

The rankings show how well plans do at preventing and treating illness and providing consumer services.

If your family includes a toddler, for instance, you'd want to know how hard a plan works to keep immunizations current. Families with diabetic members can see a plan's success at keeping LDL cholesterol below critical levels. Diligence in screening for cervical cancer with a Pap test was one of 49 measures that went into evaluating commercial plans and 39 measures for judging Medicaid plans. (Medicare plans were weighed using 42 measures.)

We even included data on the number of children who were diagnosed with a common cold and did not get an antibiotic. It's a way to determine how readily caregivers hand out antibiotics on demand, a common practice that contributes to the rise in drug-resistant bugs.

The rankings also consider members' opinions about the ease of making appointments and getting care, doctors' ability to communicate effectively, and satisfaction with claims handling.

We scored 469 health plans (see the full list) on a scale of 0 to 100. Here are America's 20 best, followed by 10 tips on how to pick a plan:

Best commercial plans

Rank	Plan	State	Type	Score
1	Harvard Pilgrim Health Care of New England	Mass., Maine	HMO/POS	91.2
2	Tufts Associated Health Maintenance Organization	Mass., N.H., R.I.	HMO/POS	91.2
3	Harvard Pilgrim Health Care of New England	N.H.	HMO/POS	90.6
4	Grand Valley Health Plan	Mich.	HMO	89.1
5	Geisinger Health Plan	Pa.	HMO/POS	88.2
6	Health New England	Conn., Mass.	HMO/POS	88.1
7	Anthem Blue Cross and Blue Shield -- Connecticut		HMO/POS	87.8
8	Group Health Cooperative of South Central Wisconsin		HMO	87.8
9	Blue Cross and Blue Shield of Massachusetts		HMO/POS	87.8
10	CIGNA HealthCare of New Hampshire		HMO/POS	87.6

Best Medicare plans

Rank	Plan	State	Type	Score
1	Preferred Care	N.Y.	HMO	88.4
2	Kaiser Foundation Health Plan of Southern California		HMO	88.1
3	Geisinger Health Plan	Pa.	HMO	88.0
4	Blue Cross and Blue Shield of Massachusetts		HMO	87.9
5	Security Health Plan of Wisconsin		HMO	87.4

Best Medicaid plans

Rank	Plan	State	Type	Score
1	Fallon Community Health Plan	Mass.	HMO	89.8
2	Neighborhood Health Plan	Mass.	HMO	89.3
3	Excellus BlueCross BlueShield	N.Y.	HMO	89.3
4	Neighborhood Health Plan of Rhode Island		HMO	89.1
5	Kaiser Foundation Health Plan of Hawaii		HMO	88.3

Note: Identical scores are due to rounding.

Tips for picking the right plan for you

1. Weigh flexibility. The three main types of health plans differ in members' degrees of personal choice in selecting caregivers. Someone with diabetes or another chronic condition may want a point-of-service (POS) plan or a preferred provider organization (PPO), because each offers unrestricted access to specialists. An HMO, which limits members to physicians in a defined network, might provide enough choice and protection for someone young and healthy.

2. Check the provider network. If physicians you use are not in the plan, switching to others would be a hassle, and if you chose them for their expertise, your health might even be affected.

3. Consider coupling catastrophic care with a special fund. You can cover the high deductible in a catastrophic-care plan from a health reimbursement arrangement, or HRA, that is set up and funded by your employer. Otherwise, you can pay the deductible from a tax-deductible health savings account you set up yourself.

Continued: Monitor the maximums

 1 | 2 | next >