weights& measures What View Measures Weight What it Measures Days in A/R 25% Average length of time to receive payment (measured from the date of charge entry to the date the remittance is posted). Financial Performance 60% First-Pass Resolution Rate Collection Burden 25% 10% Percent of claims successfully resolved (paid or transferred to patient responsibility) on the initial submission. Percent of charges transferred from the primary insurer to the next-responsible party. Includes coinsurance, deductibles, and other transfers (such as noncovered services), but not copayments or realtime adjudication because those should be known at the time of service. Administrative Performance 20% Denial Rate 20% Percent of claims requiring back-end rework (includes pended and denied claims). Transaction Efficiency 20% ERA Transparency Eligibility Accuracy 10% 10% Percent of electronic remittance advice (835) denial messages with actionable explanations and clear next steps. Reflects how well the payer has adopted the HIPAA 835 standard code set. Correlation of eligibility response to adjudication outcome. Measures how well a payer s eligibility transaction predicts the outcome of a claim.
Entities included in corporate parent overall performance United health group: Cigna: HCSC: Rank Americhoice, Oxford HP, Pacificare, United HC of River Valley, United Healthcare Cigna/Healthsource, GreatWest BCBS-IL, BCBS-NM, BCBS-OK, and BCBS-TX n a t i o n a l WellPoint: Medicare-B: BCBS-CO, BCBS-CT, BCBS-GA, BCBS-IN, BCBS-KY, BCBS-NY Empire, BCBS-OH, BCBS-VA, Blue Cross-CA, Unicare Comprised of 29 states plus Medicare Railroad 1 Aetna 24.5 3 96.8% 1 12.6% 3 5.1% 2 98.8% 1 97.8% 3 2 Humana 22.5 1 96.5% 2 13.7% 4 5.6% 4 98.8% 1 98.2% 1 3 United Health Group 25.6 7 96.4% 5 12.5% 2 5.3% 3 95.9% 5 97.9% 2 4 Cigna 26.6 8 96.5% 2 18.4% 6 4.0% 1 90.0% 7 95.4% 5 5 HCSC 24.3 2 96.5% 2 27.7% 8 8.4% 8 96.1% 4 97.1% 4 6 Wellpoint 25.3 5 96.1% 6 15.2% 5 6.3% 7 91.2% 6 95.2% 6 7 Medicare-B 25.5 6 96.1% 6 24.1% 7 6.2% 5 97.1% 3 92.5% 8 8 Champus-Tricare 25.0 4 95.3% 8 9.5% 1 6.2% 5 88.6% 8 94.8% 7 Rank B l u e s 1 BCBS-RI 14.6 1 97.2% 2 4.2% 2 3.4% 1 89.5% 26 96.5% 5 2 BCBS-MA 20.6 7 96.1% 8 7.0% 3 6.3% 13 96.9% 8 97.9% 1 3 BCBS-OH 22.5 12 97.6% 1 14.3% 13 4.5% 3 92.4% 19 96.3% 9 4 BCBS-PA Capital Blue Cross 16.1 2 95.3% 15 12.1% 10 4.5% 3 94.9% 13 96.5% 5 5 BCBS-IL 23.5 13 96.9% 3 24.4% 30 6.2% 12 94.1% 15 97.1% 4 6 BCBS-NM 20.2 5 96.8% 4 27.5% 35 5.9% 11 98.5% 2 92.8% 24 7 BCBS-WA Premera 24.6 16 95.8% 12 14.5% 14 4.6% 5 94.8% 14 93.7% 22 8 BCBS-IN 26.1 24 96.6% 6 25.1% 31 4.8% 6 93.0% 18 95.1% 15 9 BCBS-PA Highmark Blue Shield 18.8 4 95.1% 19 11.8% 9 8.8% 27 96.6% 9 90.7% 31 10 BCBS-TX 24.7 17 96.6% 6 29.7% 37 10.4% 33 96.2% 10 97.6% 3 11 BCBS-SC 20.5 6 95.3% 15 27.3% 34 9.4% 29 97.0% 7 95.9% 10 12 BCBS-CO 20.9 8 95.7% 13 20.8% 23 6.8% 16 91.1% 22 93.1% 23 13 BCBS-GA 25.8 23 96.0% 9 15.1% 17 7.3% 17 88.1% 30 95.7% 11 14 BCBS-FL 24.0 14 94.8% 21 19.7% 22 8.6% 23 93.3% 17 96.4% 7 15 BCBS-VA 21.2 9 95.3% 15 12.5% 11 6.7% 15 84.3% 33 95.3% 14 16 BCBS-AZ 26.6 26 94.9% 20 22.4% 26 5.3% 8 95.2% 12 91.3% 30 16 BCBS-NC 16.6 3 95.7% 13 17.5% 19 5.4% 9 79.8% 34 94.8% 17 18 BCBS-CT 25.4 20 95.9% 10 9.0% 6 5.2% 7 79.0% 36 95.4% 13 19 BCBS-OK 30.2 32 93.4% 26 29.1% 36 8.6% 23 98.9% 1 97.8% 2 20 BCBS-KY 22.4 11 95.3% 15 27.2% 33 7.7% 20 92.4% 19 91.5% 29 21 BCBS-WA Regence 28.9 29 95.9% 10 22.8% 28 6.5% 14 86.3% 31 92.0% 27 22 BCBS-AL 25.7 22 92.3% 28 10.3% 7 8.6% 23 91.5% 21 94.2% 19 23 BCBS-MI 25.0 18 92.2% 29 15.5% 18 12.2% 37 97.9% 3 93.8% 20 24 Blue Cross-CA 33.6 35 93.7% 24 21.0% 25 8.7% 26 97.9% 3 90.2% 33 25 BCBS-MS 27.1 27 93.5% 25 26.5% 32 7.6% 19 89.3% 27 93.8% 20 26 BCBS-PA Highmark BCBS 21.6 10 92.5% 27 11.5% 8 11.0% 34 93.9% 16 87.8% 35 27 Keystone Health Plan East 29.4 31 88.1% 35 2.0% 1 9.7% 31 97.3% 6 95.7% 11 28 BCBS-AR 24.5 15 90.4% 33 22.5% 27 8.1% 22 88.5% 29 96.4% 7 29 BCBS-NJ 25.4 20 91.9% 30 8.9% 5 11.6% 35 89.1% 28 92.8% 24 30 BCBS-NY Empire 35.1 37 91.8% 31 14.6% 15 11.7% 36 95.4% 11 94.8% 17 31 BCBS-TN 25.2 19 94.2% 22 19.5% 21 7.5% 18 75.9% 37 92.7% 26 32 BCBS-LA 26.1 24 93.8% 23 20.8% 23 8.0% 21 90.3% 24 83.6% 36 33 BCBS-PA Independence BC 29.1 30 84.0% 37 7.7% 4 4.0% 2 97.7% 5 95.0% 16 34 Blue Shield-CA 30.4 33 91.0% 32 23.3% 29 9.6% 30 90.0% 25 90.4% 32 35 BCBS-DC 31.0 34 88.0% 36 14.6% 15 10.0% 32 90.5% 23 91.6% 28 36 BCBS-MD 34.9 36 89.5% 34 13.8% 12 9.0% 28 85.1% 32 88.1% 34 37 BCBS-OR 27.4 28 96.7% 5 19.4% 20 5.7% 10 79.2% 35 64.1% 37
m e d i c a r e 1 Medicare B-WA 24.8 16 97.9% 2 24.0% 16 3.6% 2 97.9% 10 94.6% 1 2 Medicare B-OR 23.2 7 98.1% 1 25.5% 26 3.9% 3 97.5% 15 93.3% 9 3 Medicare B-GA 24.5 11 97.7% 4 22.8% 5 3.1% 1 96.3% 23 93.1% 12 4 Medicare B-CT 21.5 3 97.9% 2 22.4% 2 4.2% 4 97.1% 20 91.3% 26 5 Medicare B-NC 20.0 2 97.1% 7 23.9% 14 5.2% 11 99.5% 7 90.1% 32 6 Medicare B-IL 26.5 24 97.3% 5 26.7% 31 4.8% 6 99.2% 8 92.5% 17 7 Medicare B-CA Northern 26.4 23 96.5% 11 24.1% 19 6.0% 18 99.8% 3 93.7% 5 8 Medicare B-OH 24.3 8 96.9% 9 25.6% 27 5.3% 13 99.6% 5 91.2% 27 9 Medicare B-AR 24.4 10 97.1% 7 23.0% 6 5.0% 8 95.7% 26 91.9% 22 10 Medicare B-TN 24.6 13 97.3% 5 25.3% 25 6.1% 19 97.2% 19 92.4% 19 11 Medicare B-VA 25.1 17 96.9% 9 25.0% 24 5.2% 11 94.8% 27 93.7% 5 12 Medicare B-NJ 22.7 6 96.3% 16 21.4% 1 5.1% 10 97.4% 18 90.5% 29 13 Medicare B-MI 21.6 4 95.7% 19 24.5% 20 7.1% 26 99.6% 5 92.5% 17 14 Medicare B-MA 27.7 26 96.5% 11 25.8% 28 6.5% 23 97.5% 15 93.9% 2 15 Medicare B-IN 27.5 25 96.5% 11 26.1% 29 6.3% 21 97.7% 12 92.8% 14 16 Medicare B-PA 24.5 11 95.6% 20 23.5% 10 4.9% 7 96.2% 24 92.0% 21 17 Medicare B-SC 32.1 30 96.0% 17 23.9% 14 5.6% 16 100.0% 1 92.7% 15 18 Medicare B-LA 25.3 18 96.4% 15 23.6% 12 5.8% 17 97.1% 20 90.5% 29 19 Medicare B-KY 24.7 15 96.5% 11 24.5% 20 6.4% 22 97.7% 12 90.5% 29 20 Medicare B-AZ 24.3 8 95.8% 18 24.7% 23 7.2% 27 96.5% 22 93.9% 2 21 Medicare B-CO 19.8 1 93.9% 27 23.4% 8 4.6% 5 94.4% 28 93.7% 5 22 Medicare B-NY Upstate 22.5 5 95.2% 21 22.6% 3 5.3% 13 92.8% 30 93.3% 9 23 Medicare B-MS 25.7 22 94.3% 25 24.0% 16 7.0% 24 97.8% 11 90.9% 28 24 Medicare B-AL 31.3 28 94.0% 26 24.6% 22 5.0% 8 97.7% 12 91.8% 24 25 Medicare B-TX 25.4 19 94.9% 22 23.5% 10 8.0% 28 94.2% 29 93.0% 13 26 Medicare B-CA Southern 24.6 13 93.6% 30 23.0% 6 8.6% 29 99.8% 3 92.3% 20 27 Medicare B-OK 25.6 20 94.5% 24 26.2% 30 5.4% 15 90.5% 32 93.3% 9 28 Medicare B-NY Empire 31.4 29 94.7% 23 23.4% 8 9.1% 31 98.4% 9 93.6% 8 29 Medicare B-MD 33.7 31 93.8% 29 24.0% 16 7.0% 24 97.5% 15 91.9% 22 30 Medicare B-FL 25.6 20 93.9% 27 22.6% 3 10.5% 32 95.9% 25 91.7% 25 31 Medicare B-NM 28.5 27 92.1% 31 27.5% 32 8.9% 30 91.7% 31 93.8% 4 32 Medicare B-Railroad Medicare 49.0 32 90.6% 32 23.6% 12 6.2% 20 100.0% 1 92.6% 16 Rank m e d i c a i d 1 Medicaid-IL 45.4 8 93.1% 1 3.2% 11 10.4% 3 77.4% 13 98.4% 4 2 Medicaid-LA 31.2 1 86.9% 7 0.9% 2 13.9% 7 93.6% 3 99.0% 2 3 Medicaid-KY 41.2 6 90.0% 2 4.0% 14 12.8% 6 79.2% 8 95.8% 10 4 Medicaid-OH 39.1 5 87.4% 4 4.9% 16 16.2% 8 99.9% 1 80.5% 18 5 Medicaid-NC 34.7 2 87.4% 4 2.1% 5 27.2% 13 87.7% 5 96.9% 8 6 Medicaid-NY 72.8 18 84.7% 8 3.0% 10 7.9% 1 79.1% 9 97.1% 7 7 Medicaid-VA 36.4 3 83.4% 11 6.3% 17 27.6% 14 98.9% 2 93.5% 14 8 Medicaid-AR 38.9 4 78.8% 13 4.3% 15 8.0% 2 70.5% 15 99.2% 1 9 Medicaid-MS 52.5 14 78.8% 13 2.6% 9 11.0% 4 77.2% 14 98.7% 3 10 Medicaid-FL 51.3 13 87.3% 6 3.4% 12 24.3% 11 77.9% 12 92.1% 15 11 Medicaid-AL 50.8 12 83.7% 9 2.2% 6 24.7% 12 80.6% 7 97.7% 5 12 Medicaid-MA 48.0 10 87.8% 3 20.9% 19 24.0% 10 67.6% 17 96.9% 8 13 Medicaid-GA 43.0 7 83.6% 10 0.7% 1 34.7% 18 87.1% 6 95.6% 11 14 Medicaid-NJ 67.3 16 78.6% 15 1.9% 4 29.4% 15 87.8% 4 97.2% 6 15 Medicaid-SC 45.8 9 75.3% 18 2.4% 8 30.8% 16 78.6% 10 93.6% 13 16 Medicaid-TX 57.1 15 76.2% 17 1.4% 3 21.3% 9 55.1% 18 95.6% 11 17 Medicaid-PA 71.7 17 76.4% 16 12.1% 18 34.1% 17 78.0% 11 87.6% 17 18 Medicaid-OK 49.1 11 79.1% 12 3.9% 13 41.8% 19 69.3% 16 57.4% 19 19 Medi-Cal CA 90.9 19 68.8% 19 2.3% 7 12.4% 5 6.4% 19 91.1% 16
N o r t h e a s t 1 BCBS-RI 14.6 1 97.2% 2 4.2% 14 3.4% 1 89.5% 23 96.5% 14 2 Aetna & Aetna-US Healthcare 22.6 8 96.5% 3 9.2% 25 5.1% 11 98.6% 3 97.8% 9 3 BCBS-MA 20.6 4 96.1% 7 7.0% 19 6.3% 18 96.9% 13 97.9% 8 4 BCBS-PA Capital Blue Cross 16.1 2 95.3% 14 12.1% 28 4.5% 6 94.9% 18 96.5% 14 5 United Healthcare 25.1 11 95.9% 8 12.3% 30 6.6% 20 98.6% 3 98.0% 7 6 Medicare B-CT 21.5 5 97.9% 1 22.4% 36 4.2% 3 97.1% 12 91.3% 30 7 Cigna-HealthSource 27.6 15 96.3% 5 15.2% 33 4.2% 3 91.0% 22 95.7% 17 8 Medicare B-NJ 22.7 9 96.3% 5 21.4% 35 5.1% 11 97.4% 10 90.5% 34 9 NHP-MA 42.0 33 93.5% 23 0.8% 3 4.4% 5 98.1% 6 99.1% 3 10 Medicare B-MA 27.7 16 96.5% 3 25.8% 40 6.5% 19 97.5% 9 93.9% 22 11 Medicare B-PA 24.5 10 95.6% 12 23.5% 39 4.9% 9 96.2% 16 92.0% 28 12 BCBS-PA Highmark Blue Shield 18.8 3 95.1% 16 11.8% 27 8.8% 26 96.6% 14 90.7% 32 13 Medicare B-NY Upstate 22.5 7 95.2% 15 22.6% 37 5.3% 15 92.8% 20 93.3% 26 14 CDPHP (NY) 33.2 22 95.1% 16 2.2% 9 5.7% 17 85.4% 26 97.6% 10 15 Tufts 30.5 19 95.1% 16 3.8% 13 4.7% 8 77.1% 36 99.5% 1 16 BCBS-CT 25.4 12 95.9% 8 9.0% 24 5.2% 14 79.0% 33 95.4% 19 17 Medicare B-NY Empire 31.4 21 94.7% 21 23.4% 38 9.1% 28 98.4% 5 93.6% 25 18 Unicare 31.2 20 93.9% 22 7.9% 21 7.9% 23 97.7% 7 89.4% 35 19 Harvard Pilgrim 35.0 25 95.8% 10 4.5% 15 4.6% 7 74.2% 37 98.1% 6 20 Oxford HP 41.1 31 95.7% 11 8.1% 22 7.3% 21 80.6% 28 98.4% 5 21 Healthfirst NY & NJ 41.5 32 94.8% 20 1.8% 5 7.3% 21 77.2% 35 96.5% 14 22 Keystone Health Plan East 29.0 17 88.2% 32 2.0% 8 9.6% 29 97.3% 11 95.7% 17 23 BCBS-PA Highmark BCBS 21.6 6 92.5% 25 11.5% 26 11.0% 33 93.9% 19 87.8% 37 24 Health Net-NE 39.0 28 91.5% 28 5.6% 16 10.2% 30 99.5% 1 90.6% 33 25 BCBS-NJ 25.4 12 91.9% 26 8.9% 23 11.6% 35 89.1% 24 92.8% 27 26 BCBS-NY Empire 35.1 26 91.8% 27 14.6% 32 11.7% 36 95.4% 17 94.8% 21 27 MVP Health Plan of NY 33.3 23 91.3% 29 6.1% 18 5.3% 15 80.2% 29 93.9% 22 28 BCBS-PA Independence BC 29.1 18 84.0% 37 7.7% 20 4.0% 2 97.7% 7 95.0% 20 29 Network Health (MA) 25.7 14 95.1% 16 0.7% 2 4.9% 9 49.7% 40 99.0% 4 30 Boston Medical Ctr-Health Net 39.4 29 90.9% 30 0.6% 1 10.7% 31 82.8% 27 99.3% 2 31 Fallon 40.9 30 95.6% 12 3.2% 12 5.1% 11 66.8% 39 91.9% 29 32 Group Health Inc (GHI) 37.9 27 93.1% 24 13.7% 31 8.7% 25 80.0% 30 91.2% 31 33 HIP of Greater NY 43.6 35 88.8% 31 5.7% 17 11.2% 34 91.1% 21 87.9% 36 34 Americhoice 34.9 24 86.9% 34 1.4% 4 8.8% 26 96.3% 15 79.4% 39 35 Fidelis Care NY 66.7 37 86.9% 34 2.8% 10 10.9% 32 98.9% 2 93.9% 22 36 Medicaid-NY 72.8 40 84.7% 36 3.0% 11 7.9% 23 79.1% 32 97.1% 12 37 Medicaid-MA 48.0 36 87.8% 33 20.9% 34 24.0% 37 67.6% 38 96.9% 13 38 Medicaid-NJ 67.3 38 78.6% 38 1.9% 7 29.4% 38 87.8% 25 97.2% 11 39 Medicaid-PA 71.7 39 76.4% 39 12.1% 28 34.1% 39 78.0% 34 87.6% 38 40 Horizon NJ Health 43.3 34 73.9% 40 1.8% 5 37.4% 40 79.7% 31 72.4% 40
S o u t h 1 United Healthcare 22.7 6 97.1% 3 13.2% 19 5.0% 3 96.2% 15 98.4% 4 2 Aetna & Aetna-US Healthcare 23.8 10 96.6% 8 14.2% 21 5.3% 8 98.6% 6 98.1% 6 3 Humana 23.5 9 96.4% 9 11.5% 17 6.2% 17 98.6% 6 98.4% 4 4 Medicare B-GA 24.5 13 97.7% 1 22.8% 31 3.1% 1 96.3% 14 93.1% 27 5 Cigna-HealthSource 23.4 8 97.0% 6 17.5% 24 3.8% 2 91.3% 24 96.1% 14 6 Medicare B-NC 20.0 3 97.1% 3 23.9% 35 5.2% 6 99.5% 3 90.1% 42 7 Medicare B-AR 24.4 12 97.1% 3 23.0% 32 5.0% 3 95.7% 17 91.9% 34 8 Medicare B-TN 24.6 15 97.3% 2 25.3% 41 6.1% 16 97.2% 11 92.4% 32 9 Medicare B-VA 25.1 16 96.9% 7 25.0% 40 5.2% 6 94.8% 18 93.7% 23 10 Southern Health Services 25.3 18 94.7% 19 9.4% 15 5.6% 12 91.1% 25 97.0% 9 11 Champus-Tricare PGBA 23.3 7 95.5% 14 8.8% 14 5.9% 15 89.1% 30 95.0% 19 12 Medicare B-SC 32.1 32 96.0% 11 23.9% 35 5.6% 12 100.0% 1 92.7% 30 13 Medicare B-LA 25.3 18 96.4% 9 23.6% 34 5.8% 14 97.1% 12 90.5% 41 14 BCBS-SC 20.5 4 95.3% 15 27.3% 44 9.4% 33 97.0% 13 95.9% 15 15 BCBS-GA 25.8 24 96.0% 11 15.1% 23 7.3% 23 88.1% 32 95.7% 16 16 Amerigroup-GA 18.8 2 94.4% 21 1.6% 3 10.8% 36 94.6% 19 91.4% 39 17 BCBS-FL 24.0 11 94.8% 17 19.7% 27 8.6% 29 93.3% 21 96.4% 12 18 BCBS-VA 21.2 5 95.3% 15 12.5% 18 6.7% 19 84.3% 37 95.3% 18 19 BCBS-NC 16.6 1 95.7% 13 17.5% 24 5.4% 9 79.8% 39 94.8% 20 20 Medicare B-MS 25.7 22 94.3% 22 24.0% 37 7.0% 20 97.8% 8 90.9% 40 21 Medicare B-AL 31.3 31 94.0% 24 24.6% 39 5.0% 3 97.7% 9 91.8% 36 22 BCBS-OK 30.2 27 93.4% 29 29.1% 45 8.6% 29 98.9% 4 97.8% 7 23 Avmed 40.6 38 94.8% 17 7.0% 13 6.3% 18 NA NA 93.0% 28 24 Medicare B-OK 25.6 20 94.5% 20 26.2% 42 5.4% 9 90.5% 26 93.3% 26 25 United HC of River Valley 30.8 28 92.5% 30 6.5% 12 7.1% 22 88.1% 32 96.9% 10 26 Medicare B-MD 33.7 33 93.8% 26 24.0% 37 7.0% 20 97.5% 10 91.9% 34 27 BCBS-AL 25.7 22 92.3% 31 10.3% 16 8.6% 29 91.5% 23 94.2% 21 28 Medicare B-FL 25.6 20 93.9% 25 22.6% 30 10.5% 35 95.9% 16 91.7% 37 29 BCBS-MS 27.1 26 93.5% 28 26.5% 43 7.6% 25 89.3% 29 93.8% 22 30 BCBS-AR 24.5 13 90.4% 33 22.5% 29 8.1% 28 88.5% 31 96.4% 12 31 Medicare B-Railroad Medicare 48.0 41 91.3% 32 23.3% 33 5.5% 11 100.0% 1 93.0% 28 32 BCBS-TN 25.2 17 94.2% 23 19.5% 26 7.5% 24 75.9% 43 92.7% 30 33 BCBS-LA 26.1 25 93.8% 26 20.8% 28 8.0% 26 90.3% 28 83.6% 44 34 Medicaid-LA 31.2 30 86.9% 38 0.9% 2 13.9% 38 93.6% 20 99.0% 2 35 BCBS-DC 31.0 29 88.0% 35 14.6% 22 10.0% 34 90.5% 26 91.6% 38 36 BCBS-MD 34.9 35 89.5% 34 13.8% 20 9.0% 32 85.1% 36 88.1% 43 37 Medicaid-NC 34.7 34 87.4% 36 2.1% 4 27.2% 41 87.7% 34 96.9% 10 38 Medicaid-VA 36.4 36 83.4% 41 6.3% 11 27.6% 42 98.9% 4 93.5% 25 39 Medicaid-AR 38.9 37 78.8% 43 4.3% 10 8.0% 26 70.5% 44 99.2% 1 40 Medicaid-MS 52.5 45 78.8% 43 2.6% 7 11.0% 37 77.2% 42 98.7% 3 41 Medicaid-FL 51.3 44 87.3% 37 3.4% 8 24.3% 39 77.9% 41 92.1% 33 42 Medicaid-AL 50.8 43 83.7% 39 2.2% 5 24.7% 40 80.6% 38 97.7% 8 43 Medicaid-GA 43.0 39 83.6% 40 0.7% 1 34.7% 44 87.1% 35 95.6% 17 44 Medicaid-SC 45.8 40 75.3% 45 2.4% 6 30.8% 43 78.6% 40 93.6% 24 45 Medicaid-OK 49.1 42 79.1% 42 3.9% 9 41.8% 45 69.3% 45 57.4% 45
M i d w e s t 1 Aetna & Aetna-US Healthcare 21.4 2 97.0% 5 13.1% 9 4.2% 3 98.9% 9 97.6% 4 2 United Healthcare 22.1 5 97.6% 1 15.3% 12 4.4% 4 96.5% 15 98.6% 1 3 Humana 19.2 1 96.4% 14 14.4% 11 4.9% 9 99.0% 6 97.8% 3 4 HealthPartners 21.6 3 96.7% 9 19.9% 15 3.5% 2 99.0% 6 95.2% 11 5 BCBS-OH 22.5 7 97.6% 1 14.3% 10 4.5% 5 92.4% 23 96.3% 8 6 Medicare B-IL 26.5 14 97.3% 3 26.7% 25 4.8% 6 99.2% 5 92.5% 16 7 BCBS-IL 23.5 8 96.9% 6 24.4% 17 6.2% 11 94.1% 17 97.1% 7 8 Medicare B-OH 24.3 9 96.9% 6 25.6% 22 5.3% 10 99.6% 3 91.2% 21 9 BCBS-IN 26.1 13 96.6% 10 25.1% 21 4.8% 6 93.0% 21 95.1% 12 10 Medicare B-MI 21.6 3 95.7% 15 24.5% 18 7.1% 17 99.6% 3 92.5% 16 11 Medical Mutual Of Ohio 29.0 16 96.9% 6 18.4% 14 6.5% 15 99.0% 6 89.9% 23 12 Medicare B-IN 27.5 15 96.5% 12 26.1% 24 6.3% 12 97.7% 12 92.8% 15 13 Medicare B-KY 24.7 10 96.5% 12 24.5% 18 6.4% 13 97.7% 12 90.5% 22 14 Cigna-HealthSource 37.3 20 96.6% 10 21.8% 16 3.3% 1 92.8% 22 94.4% 13 15 Molina Healthcare of Ohio 32.9 19 93.9% 18 2.4% 4 7.2% 18 NA NA 97.2% 6 16 Summacare 29.4 17 97.2% 4 10.7% 8 4.8% 6 NA NA 84.9% 25 17 Medica 24.9 11 93.0% 20 26.0% 23 8.6% 20 97.5% 14 96.2% 9 18 BCBS-KY 22.4 6 95.3% 16 27.2% 26 7.7% 19 92.4% 23 91.5% 20 19 Caresource 46.2 25 94.1% 17 1.6% 2 12.0% 23 96.1% 16 97.4% 5 20 BCBS-MI 25.0 12 92.2% 21 15.5% 13 12.2% 24 97.9% 11 93.8% 14 21 Buckeye Community Health Plan 30.3 18 90.4% 24 0.7% 1 7.0% 16 NA NA 92.0% 18 22 Medicare B-Railroad Medicare 46.1 24 90.7% 23 24.6% 20 6.4% 13 100.0% 1 91.9% 19 23 Unison Health Plan 48.7 26 91.6% 22 2.2% 3 9.8% 21 98.2% 10 87.3% 24 24 Medicaid-IL 45.4 23 93.1% 19 3.2% 5 10.4% 22 77.4% 26 98.4% 2 25 Medicaid-KY 41.2 22 90.0% 25 4.0% 6 12.8% 25 79.2% 25 95.8% 10 26 Medicaid-OH 39.1 21 87.4% 26 4.9% 7 16.2% 26 99.9% 2 80.5% 26
w e s t 1 Humana 25.9 14 96.8% 4 16.3% 15 6.1% 16 99.1% 3 98.6% 1 1 United Healthcare 25.0 11 97.0% 3 13.8% 11 5.0% 9 95.6% 13 98.0% 3 3 Aetna & Aetna-US Healthcare 28.0 20 96.8% 4 13.1% 10 5.6% 12 99.0% 4 97.8% 4 4 Medicare B-WA 24.8 10 97.9% 2 24.0% 27 3.6% 1 97.9% 7 94.6% 10 5 Medicare B-OR 23.2 4 98.1% 1 25.5% 30 3.9% 2 97.5% 10 93.3% 16 6 Champus-Tricare WPS 25.4 12 96.5% 9 9.3% 9 4.1% 5 98.5% 5 92.5% 20 7 BCBS-NM 20.2 2 96.8% 4 27.5% 31 5.9% 14 98.5% 5 92.8% 19 8 BCBS-WA Premera 24.6 7 95.8% 13 14.5% 12 4.6% 7 94.8% 16 93.7% 13 9 Medicare B-CA Northern 26.4 15 96.5% 9 24.1% 28 6.0% 15 99.8% 1 93.7% 13 10 Cigna-HealthSource 27.5 19 96.0% 11 19.9% 17 4.3% 6 93.4% 19 94.9% 8 11 Providence Health Plan 27.0 17 95.7% 15 15.2% 14 4.0% 4 87.8% 26 94.8% 9 12 Medicare B-AZ 24.3 6 95.8% 13 24.7% 29 7.2% 19 96.5% 11 93.9% 11 13 BCBS-TX 24.7 9 96.6% 8 29.7% 33 10.4% 28 96.2% 12 97.6% 5 13 Medicare B-CO 19.8 1 93.9% 22 23.4% 24 4.6% 7 94.4% 17 93.7% 13 15 Health Net-AZ 28.0 20 94.7% 19 4.6% 7 5.0% 9 97.8% 9 86.8% 28 16 BCBS-CO 20.9 3 95.7% 15 20.8% 18 6.8% 18 91.1% 23 93.1% 17 17 BCBS-AZ 26.6 16 94.9% 17 22.4% 20 5.3% 11 95.2% 15 91.3% 23 18 Medicare B-TX 25.4 12 94.9% 17 23.5% 25 8.0% 20 94.2% 18 93.0% 18 19 Medicare B-CA Southern 24.6 7 93.6% 24 23.0% 22 8.6% 23 99.8% 1 92.3% 21 20 BCBS-WA Regence 28.9 23 95.9% 12 22.8% 21 6.5% 17 86.3% 27 92.0% 22 21 Molina Healthcare of NM 23.8 5 89.3% 29 2.5% 5 8.0% 20 NA NA 96.3% 6 22 Blue Cross-CA 33.6 26 93.7% 23 21.0% 19 8.7% 24 97.9% 7 90.2% 27 23 Pacificare 37.6 29 94.6% 20 2.1% 3 3.9% 2 76.3% 29 91.0% 25 24 Medicare B-NM 28.5 22 92.1% 26 27.5% 31 8.9% 26 91.7% 22 93.8% 12 25 Mercy Care Plan of Arizona 35.6 28 94.0% 21 5.1% 8 8.7% 24 NA NA 78.3% 31 26 Blue Shield-CA 30.4 25 91.0% 27 23.3% 23 9.6% 27 90.0% 24 90.4% 26 27 BCBS-OR 27.4 18 96.7% 7 19.4% 16 5.7% 13 79.2% 28 64.1% 33 28 Great West Healthcare 35.5 27 92.3% 25 23.9% 26 8.5% 22 61.8% 30 86.8% 28 29 Health Net-CA-OR 46.7 30 90.0% 28 14.9% 13 16.0% 32 89.3% 25 84.3% 30 30 Amerigroup-TX 29.1 24 88.8% 30 2.5% 5 15.9% 31 95.3% 14 67.1% 32 31 Superior Health Plan 48.0 31 82.3% 31 1.6% 2 13.4% 30 57.5% 31 98.2% 2 32 Medicaid-TX 57.1 32 76.2% 32 1.4% 1 21.3% 33 55.1% 32 95.6% 7 33 Medi-Cal CA 90.9 33 68.8% 33 2.3% 4 12.4% 29 6.4% 33 91.1% 24