ALBANY, N.Y. – September 18, 2023 – Once again this year, CDPHP has some of the highest-rated commercial health plans in the nation, according to recent NCQA Health Plan Ratings.
“Despite the massive upheaval the health care industry has faced over the last several years, the fact that CDPHP has yet again been named among the highest-rated plans in New York state and the nation by NCQA, one of the most well-respected health care quality organizations in the U.S., is a testament to our valued employees and our loyal membership,” said John D. Bennett, MD, president and CEO, CDPHP. “I highly encourage anyone shopping for health care coverage this fall to do your research, compare plan benefits and extras, and keep these ratings in mind,” added Bennett.
NCQA rates plans on a scale of 1 to 5, where 5 is the highest score and 1 is the lowest. Plans were scored on patient experience, prevention, and treatment, as well as NCQA Accreditation.
Below is a breakdown of how commercial CDPHP plans are rated for 2023*:
- Capital District Physicians’ Health Plan, Inc. – Commercial (HMO) – 4.5 out of 5
- Capital District Physicians’ Healthcare Network – Commercial (HMO/POS Combined) – 4.5 out of 5
- CDPHP Universal Benefits, Inc. – Commercial (PPO) – 4.5 out of 5
- Capital District Physicians’ Healthcare Network – Commercial (PPO) – 4.5 out of 5
CDPHP will complement our award-winning plans with the following member-focused enhancements for 2024:
An enhanced prescription drug network
The 2024 prescription drug benefit will include preferred pharmacies which have partnered with CDPHP to offer lower dispensing fees and drug costs, as well as participation in the Rx for Less Program (which offers dozens of medications for as low as a penny a pill).
$0 Tier 1 medications for members under age 19
There will be no member cost-share for Tier 1 drugs in the preferred network for members under the age of 19.
$0 outpatient mental health and substance use services
There will be no member cost-share for outpatient facility-based mental health and substance use disorder treatment services.
Parent and baby class reimbursement
Parent and baby classes (e.g., yoga, swim lessons) are now eligible for reimbursement under the fitness reimbursement benefit.
Unless otherwise noted, all above-mentioned benefits take effect on January 1, 2024.
*The National Committee for Quality Assurance (NCQA) is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS® is the most widely used performance measurement tool in health care. NCQA's website (www.ncqa.org) contains information to help consumers, employers and others make informed health care choices
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About CDPHP®
Established in 1984, CDPHP is a physician-founded, member-focused and community-based not-for-profit health plan that offers high-quality affordable health insurance plans to members in 36 counties throughout New York. CDPHP is also on Facebook, Twitter, LinkedIn, and Instagram.