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The NCQA's 2026 health plan ratings show a quality surge — but only among nonprofits. Eighteen plans earned a perfect 5-star rating, up from 11 last year, and every single one is a nonprofit. For-profit giants like Cigna and Centene continue to trail, averaging between 3 and 4 stars, even as consumer frustration with insurers grows.
The National Committee for Quality Assurance (NCQA) released its 2026 health plan ratings, and the headline is clear: nonprofits are pulling away from the pack. Eighteen plans achieved the coveted 5-star rating — up from 11 in 2025 — and all 18 are nonprofits. Nine of those top scorers are operated by Kaiser Permanente, which has led the nation in top-rated plans for 11 consecutive rating cycles.
Overall, the industry is trending upward, with the average plan rating nudging from 3.483 to 3.493. Standout improvements were seen in behavioral health — particularly follow-up care after mental illness hospitalizations — and chronic disease management, where plans improved on nearly 80% of measures. However, Medicare plan ratings dipped slightly, even as commercial and Medicaid plans improved.
For-profit insurers, meanwhile, continue to underperform. Researchers attribute the gap to structural incentives: for-profits prioritize shareholder returns, while nonprofits reinvest surplus funds into patient care and quality improvement.
By the Numbers:
Why it matters: As Americans grow increasingly frustrated with rising healthcare costs and insurer practices, these ratings offer a data-backed look at where quality is — and isn't — being delivered. The persistent nonprofit-vs-for-profit gap raises important questions about how ownership structure shapes patient outcomes.
