9/22/2026
PITTSBURGH — UPMC announced today that several of its Insurance Services Division products received 4.5- or 5-star ratings from the National Committee for Quality Assurance (NCQA). This makes these plans among the highest NCQA-rated plans in both Pennsylvania and the nation in 2026.
“Earning these high-quality ratings across our plans reflects our unwavering commitment to clinical quality improvement and the betterment of healthcare outcomes for the members and communities we passionately serve,” said Carrie Whitcher, UPMC Health Plan’s chief quality officer. “This commitment to quality supports our members’ access to high-quality care and a positive member experience.”
Eight UPMC Insurance Services Division products received NCQA Health Plan Ratings of 4 stars or higher. Highlights include the following:
-
UPMC Commercial HMO products issued by UPMC Health Plan Inc. and administered by UPMC Benefit Management Services Inc. earned 5 out of 5 stars in NCQA’s Commercial Health Plan Ratings 2026, making them the top-rated commercial HMO plans in Pennsylvania and among the top 1.6 percent nationally.
-
UPMC Benefit Management Services is among the top-rated commercial EPO/PPO plans in Pennsylvania, receiving 4.5 stars in NCQA’s Commercial Health Plan Ratings 2026. It is among the top 6 percent nationally.
-
UPMC for You is among the top 6 percent of Medicaid plans in the nation, maintaining 4.5 stars in NCQA’s Medicaid Health Plan Ratings 2026. No Pennsylvania plans received a 5-star rating, and only two other plans in the state attained a 4.5-star rating. Both of those plans operate exclusively in the Community HealthChoices program.
In addition to achieving strong Health Plan Ratings, all eight Insurance Services Division products are NCQA Health Plan Accredited. NCQA Accreditation recognizes health plans that demonstrate excellence in managing and improving the quality of care, member experience, and operational performance across their provider network and administrative services.
How plans are rated
NCQA accredits and certifies a wide range of healthcare organizations, and it manages the evolution of Healthcare Effectiveness Data and Information Set (HEDIS®), the performance measurement tool used by more than 90 percent of the nation’s health plans. Health plans are rated in three categories:
-
Private/Commercial plans in which people enroll through work or on their own
-
Plans that serve Medicare beneficiaries in the Medicare Advantage program (not supplemental plans)
-
Plans that serve Medicaid beneficiaries
NCQA Health Plan Ratings are calculated on a 5-star scale using a weighted average of HEDIS® clinical quality measures and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) member experience measures. Additional points are awarded for plans that have current NCQA Accreditation.
NCQA rates health plans that choose to report measures publicly.
