January 6, 2021 (Smithfield, RI) – Neighborhood Health Plan of Rhode Island (Neighborhood) capped off 2021 with significant achievements and a demonstrated commitment to ensuring Rhode Island’s low-income populations have access to high quality health care. Altogether, these results mark an important milestone for Neighborhood: 20 years of continuous high quality performance as a Medicaid health plan.
In the 2021 Consumer Assessment of Health Care Providers and Systems (CAHPS®) Medicaid Adult Member Satisfaction survey, members’ feedback placed Neighborhood as the No. 1 Medicaid Health Plan in the country for Rating of Health Plan.[i] The national survey measures Medicaid members’ experiences with health plans and associated providers, and is used as one of the quality measures in the National Committee for Quality Assurance’s (NCQA’s) Health Plan Rating and Accreditation.
Equally significant is Neighborhood’s success in assuring the highest quality of medical care for its members. In 2021, Neighborhood achieved a 5-star rating from NCQA for the Prevention component of the annual Health Plan Rating. The Prevention rating is based on nine different measures of clinical excellence. Neighborhood is one of only two Medicaid Health Plans out of 185 across the country to achieve this rating in 2021 and the only Medicaid Health Plan to do so in Rhode Island. This achievement is a testament to Neighborhood’s exceptional network of providers and their strong partnership with Neighborhood to serve Medicaid members with high-quality clinical care.
“What began as a dream by Rhode Island’s community health centers and the state’s initiative to build RIte Care, Rhode Island’s Medicaid managed care program, has evolved into a health plan with a history of delivering high quality health care to those who are most often at-risk for poor health outcomes,” said Peter Marino, president and CEO of Neighborhood. “To be consistently rated a top Medicaid plan in the country demonstrates the trust our employees and provider network have earned from our members and, in 2021, to be the number one Medicaid health plan in the country makes me tremendously proud given the challenges we have faced together during the pandemic.”
Neighborhood’s two decades of high quality performance is illustrated by the organization’s consistent collective record of earning high ratings and accreditation from NCQA, high scores on CAHPS surveys and strong clinical performance results on the Healthcare Effectiveness Data and Information Set (HEDIS®).[ii] Highlights of Neighborhood’s quality performance include:
Longevity as Top-Rated Medicaid Health Plan
- For 20 consecutive years achieved the highest NCQA Accreditation status
- For 17 consecutive years rated above the national Medicaid Quality Compass 90th percentile on the CAHPS Medicaid Adult – Rating of Health Plan (9+10) survey measure [iii]
- In 2006, became the first Medicaid Health Plan to be Ranked #1 nationally by the US News & World Report in conjunction with NCQA Health Insurance Plan Rankings
- Consistently rated in the top tier nationally according to NCQA’s Medicaid Health Plan Ratings
2021 NCQA’s Medicaid Health Plan Ratings
- One of 14 (out of 185) Medicaid Health Plans in the country rated 4.5 out of a maximum possible rating of 5
- One of two Medicaid Health Plans in the country and the only Medicaid Health Plan in Rhode Island to achieve 5 out of 5 stars in the 2021 Prevention Rating category
- The Plan achieved 5 out of 5 stars in Childhood, Adolescents and Flu Immunizations; Prenatal Checkups; Postpartum Care and Cervical Cancer Screenings in the Prevention Rating category – a testament to Neighborhood’s exceptional network of providers and their strong partnership with Neighborhood to serve Medicaid members, in particular mothers and children.
2021 CAHPS Medicaid Adult Member Satisfaction Survey
- Members rated Neighborhood the #1 Medicaid Health Plan in the country for Rating of Health Plan
- The first Medicaid Health Plan in the country to earn a score at or above 90 percent (90.15%) for satisfaction for Rating of Health Plan (8+9+10)
- Achieved the 90th percentile in Rating of Specialist
- Achieved a +69 Net Promoter Score (NPS), which is classified as “Excellent” and one point shy of “World Class”. (NPS is a metric used in customer experience programs to measure the loyalty of customers to a company.)
Marino added, “These impressive results are a testament to the state’s foresight and collaboration to invest in a high quality managed care program with rigorous, member-centric quality incentives at its core. These incentives have become a cornerstone to all government-funded plans in Rhode Island.”
Initially serving 1,490 disadvantaged pregnant women and children in 1994 through the state’s RIte Care program, Neighborhood now serves nearly 217,000 members – one in five Rhode Islanders – with 81% of its membership Medicaid-eligible, 6% dually-eligible for Medicare and Medicaid, and 13% who purchase Neighborhood’s commercial plans through HealthSourceRI. CAHPS Medicaid Adult surveys include feedback from members in Neighborhood’s Medicaid Expansion population, adults with disabilities, low-income RIte Care parents and older adults who are Medicaid-Medicare dual eligible.
“I still remember sitting in the basement of the Department of Health in 1993 and working with the health care reform commission to develop RIte Care,” said Dr. Pablo Rodriguez, medical director for community affairs at Care New England and a member of Neighborhood’s board. “I kept imagining what a health plan to serve the underserved would look like – that’s why it is so fulfilling to sit here today and have Neighborhood members confirming they receive the care they need. It’s a dream come true to know we have been doing it for 20 years and continue to raise the bar.”
As an advocate for the state’s underserved populations, Neighborhood attributes several factors – that complement the state’s investment in RIte Care –to its longstanding success with ensuring effective and accessible medical and behavioral health care and support services.
- Neighborhood’s long history of collaboration with the state’s federally-qualified community health centers to bring primary care services and programs closer to where members live and work.
- The growth of a large, multi-specialty provider network committed to serving Medicaid-eligible Rhode Islanders.
- Deep connections throughout the state with non-profit organizations that are trusted resources to members and to Neighborhood.
- An enduring commitment to breaking down the barriers caused by social determinants of health, such as housing, food, transportation, education and job opportunities.
- A company culture that is driven by purpose – to make each day better for members.
“As evidenced by Neighborhood’s ability to improve health equity for underserved people in an effective, meaningful way that has stood the test of time, one of our best decisions was investing in Neighborhood 20 years ago to help the organization become a nonprofit,” said Neil D. Steinberg, president and CEO of the Rhode Island Foundation. “We commend Neighborhood for continuously meeting the rigor set forth by the state to help make it easier for members to access health care services and the resources they need to live well and to become a Rhode Island community asset.”
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA’s website (ncqa.org) contains information to help consumers, employers and others make more informed health care choices. NCQA can be found on Twitter @ncqa, on Facebook at facebook.com/NCQA.org and on LinkedIn at linkedin.com/company/ncqa/.
Neighborhood Health Plan of Rhode Island (Neighborhood) is a not-for-profit health maintenance organization (HMO) founded in December 1993 in partnership with Rhode Island’s Community Health Centers to ensure everyone in the state has access to high quality, cost-effective health care. Neighborhood serves nearly 217,000 members in the state with 81 percent of its membership Medicaid eligible through its ACCESS and TRUST plans and 6 percent of its membership utilizing Neighborhood’s INTEGRITY Medicare-Medicaid Plan (MMP). About 13 percent of Neighborhood’s members are individuals, families and small businesses who select one of eight Neighborhood commercial plans available through the health exchange, HealthSource RI. Of these members, about 85 percent qualify for federal subsidies to cover a portion of their costs. Today, Neighborhood—with over 600 employees and $1.4 billion in revenue—serves one out of every five Rhode Islanders. Learn more at nhpri.org.