ALBANY, NY / ACCESS Newswire / October 13, 2025 / CDPHP is pleased to announce that the locally-based, physician founded health plan has some of the highest-rated commercial and Medicare health plans in the nation, according to NCQA's Commercial Health Plan Ratings 2025 and the Centers for Medicare & Medicaid Services Star Ratings program.
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 Health Plan Accreditation.
Below is a breakdown of how commercial CDPHP plans are rated for 2025*:
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
In addition, CDPHP is thrilled that CMS has once again rated both its Medicare Advantage PPO plans and Medicare Advantage HMO plans with 4.5 out of 5 Star Ratings, among the highest in New York state and the country.
Medicare Star Ratings** provide consumers with valuable information needed to compare health plans. Each year, CMS rates Medicare plans on a scale of 1 to 5 stars, with 5 stars representing the highest quality. The Star Rating System is an important feature of the Medicare Advantage program, as it encourages health insurers to strive for higher quality, which results in members receiving better care.
Scores are based on several key categories, including:
Preventive care services, such as screening tests and vaccines
Management of long-term health conditions
Member experience with the health and drug plan
Member complaints, including problems getting services
Health and drug plan customer service
Pharmacy services, such as accuracy of drug pricing and drug safety
Improvement in the health and drug plan's performance year over year
"At CDPHP, quality isn't just a goal - it's the foundation of everything we do. These ratings are a powerful testament to our unwavering commitment to ensuring every member receives the right care, in the right setting, at the right time," said Brian O'Grady, president and CEO of CDPHP. "As you and your family prepare to make important health care choices this fall, I encourage you to consider the value of a not-for-profit, community-based health plan-one that puts members first and keeps care personal."
For more information on the difference a CDPHP health plan can make, visit https://plans.cdphp.com.
CDPHP is an HMO and PPO plan that contracts with the federal government. Enrollment in CDPHP Medicare plans depends on contract renewal.
*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.
**Every year, Medicare evaluates plans based on a 5-star rating system.
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, X, LinkedIn, and Instagram.
Contact: Natalia Burkart
(518) 542-8524
natalia.burkart@cdphp.com
SOURCE: CDPHP
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