CDPHP Achieves High NCQA and CMS Ratings for Commercial and Medicare Plans

CDPHP, a health plan based in New York and founded by physicians, has received high ratings in both commercial and Medicare health plan categories for 2025. The National Committee for Quality Assurance (NCQA) awarded several commercial plans from CDPHP a score of 4.5 out of 5, reflecting strong performance in patient experience, prevention, treatment, and overall health plan accreditation. These scores place CDPHP among the top-rated plans nationally, demonstrating competitive quality measures in the commercial insurance market.

In parallel, the Centers for Medicare & Medicaid Services (CMS) recognized CDPHP's Medicare Advantage PPO and HMO plans with 4.5 out of 5 stars, positioning these plans among the highest-rated in New York state and the country. CMS evaluates Medicare plans based on preventive care, management of chronic conditions, member satisfaction, complaints, customer service, pharmacy services, and year-over-year improvement.

These ratings indicate CDPHP's focus on delivering efficient care and positive member experiences, emphasizing preventive healthcare and effective management of long-term conditions. The recognition also underscores the plan's compliance with federal regulatory standards and its commitment to quality improvement in Medicare Advantage programs.

As a not-for-profit, community-based insurer operating in 36 New York counties, CDPHP’s performance in these rankings highlights the potential impact of localized, physician-founded health plans on health insurance quality. The ratings serve as important indicators for stakeholders including employers, members, and healthcare providers when assessing plan options in competitive commercial and Medicare markets.

CDPHP's use of established evaluation tools such as NCQA's HEDIS® measures and CMS's Star Rating System aligns with industry trends emphasizing quality metrics and transparency in plan performance. These ratings may assist in informed decision-making during open enrollment periods, where consumers evaluate benefit options across different payer models. Additionally, CDPHP’s approach reflects ongoing regulatory and market pressures to enhance care quality while managing costs effectively in the insurance sector.