September 23, 2026  – The number of health plans earning the highest quality rating from the National Committee for Quality Assurance jumped sharply in 2026, with Medicaid plans showing particularly broad improvement across quality measures.

NCQA released its annual Health Plan Ratings on Sept. 16, evaluating nearly 1,000 commercial, Medicare Advantage and Medicaid plans. Eighteen plans received a 5-star rating this year, a 64% increase from 2025. Another 53 plans earned 4.5 stars.

Of the 18 plans receiving the top rating, nine were commercial plans, five were Medicare Advantage plans and four were Medicaid plans.

The ratings measure more than member satisfaction. NCQA evaluates plans using clinical quality measures, patient experience data and reviews of plan structures and quality improvement processes. Data come from sources including the Healthcare Effectiveness Data and Information Set, commonly known as HEDIS, and Consumer Assessment of Healthcare Providers and Systems surveys.

The latest results suggest quality gains extended well beyond the plans earning the highest ratings.

Medicaid showed the broadest improvement of the three insurance markets, with 89% of measures improving year over year. Average benchmark performance across Medicaid, Medicare Advantage and commercial plans increased between 1.6 and 1.8 percentage points. Differences between high- and low-performing plans also narrowed.

Behavioral health was one of the strongest areas of improvement.

Performance on follow-up care after hospitalization for mental illness increased by 9 percentage points among Medicaid plans. Commercial plans improved by 8.9 percentage points, while Medicare Advantage plans posted an 11.9-point increase. NCQA attributed the broader behavioral health gains in part to increased attention to mental health access, care coordination and follow-up services.

Chronic disease management also improved. Of 28 measures in this category, 22 posted year-over-year gains. That means performance increased on nearly 80% of the chronic care measures included in the ratings.

Not every measure moved in the right direction. NCQA noted declining performance for diabetic eye exams, pointing to preventive care as an area that may require additional attention.

The findings have implications beyond the annual ratings themselves. States can use NCQA performance information when evaluating Medicaid managed care organizations, while many states require Medicaid plans to maintain NCQA accreditation. Quality data are also increasingly connected to value-based payment arrangements that tie financial incentives to outcomes and performance rather than the volume of services delivered.

For Medicaid managed care programs, that connection is especially important. States rely on private health plans to manage care for millions of beneficiaries and are increasingly looking for measurable evidence that those arrangements improve quality and patient outcomes.

While 2026 results show progress in areas that directly affect patients, including behavioral health and chronic disease management, it is also important to note the importance of public performance measurement in creating accountability.