Dive Brief:

• Health plans are generally performing better on quality and performance ratings, though nonprofit insurers continue to surge past their for-profit peers.
• The National Committee for Quality Assurance released its 2026 ratings on Tuesday, which score commercial, Medicare and Medicaid plans across a range of measures of clinical quality, patient experience and health outcomes. Eighteen plans nabbed the standards organization’s highest 5-star rating, up from 11 last year. All of them are nonprofits.
• Of the major publicly traded carriers, CVS had the highest scores, averaging at about 4 stars, according to a Healthcare Dive analysis of the data. Meanwhile, plans’ average rating ticked up slightly, from 3.483 last year to 3.493 in 2026 thanks to improvements in commercial and Medicaid plans, though Medicare insurers’ average rating slipped.

Dive Insight:

The NCQA, a private nonprofit that maintains some of the most commonly used performance measures in healthcare, publishes ratings annually for plans that choose to publicly report data, with the goal of helping consumers and regulators determine quality and effectiveness of plans.

The standards group uses the same system the federal government uses to rate privatized Medicare Advantage plans: a 0 to 5 star scale, with 5 being the highest possible achievement.

Plans tout their ratings, especially if they outperform the average. But overall performance has been ticking up in recent years, as insurers invest heavily in continuity of care, patient communication and other areas. Last year, the 11 plans that reached 5-star status was more than double 2024’s total. And now that figure has jumped again, to 18.

The NCQA said that higher average quality scores, paired with shrinking variation between high- and low-performing plans, is evidence of improving quality industrywide. The group also called out gains in behavioral health performance from insurers investing more heavily in mental health access and care coordination.

Follow-up after hospitalization for mental illness was among the most improved measures year over year, the NCQA said. Similarly, plans improved their performance on nearly four-fifths of chronic disease management measures.

"The progress reflected in this year's Health Plan Ratings is encouraging because it demonstrates meaningful improvement in the areas that matter most to patients, such as behavioral health and chronic disease management," Dr. Vivek Garg, president and CEO of NCQA, said in a statement.

The 2026 ratings, which are largely based on 2025 data, are the latest to illustrate how for-profit insurers underperform on quality compared to their nonprofit peers.

Researchers chalk the delta up to core structural differences between for-profit and nonprofit companies: For-profits try to maximize short-term value to deliver returns to Wall Street or private owners, while nonprofits have no shareholders and keep or reinvest excess income. As a result, nonprofit health insurers generally allocate more funds directly into patient care and quality improvement, according to research.

Of the 18 nonprofits that scored a 5-star rating, nine were operated by California-based integrated healthcare giant Kaiser Permanente. Kaiser has more 5-star and 4.5-star plans combined than any other healthcare organization for the 11th back-to-back ratings cycle, according to a press release from the company.

In comparison, ratings for publicly traded for-profit giants varied widely, though all averaged loosely between 3 and 4 stars.

Currently, major insurers are embarking on a major push to improve their standing with consumers, as Americans fed up with rising healthcare prices blame plans for spiking costs.

Still, consumer satisfaction with their plans is slipping, partially due to the belief that insurers are prioritizing their profits over patient care, according to JD Power.