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    Maryland Department of Health
    HealthChoice

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    HealthChoice Quality Assurance Annual Reports

    ​Maryland Medicaid annually audits each of the nine HealthChoice managed care organizations (MCOs). The audit evaluates the services and care that the MCOs provide members. The audit accesses each MCO to ensure they meet the standards for:

    • Quality
    • Access
    • Timeliness 

    Maryland Medicaid uses the audit findings to make improvements and create best practices. 

    You can find the results in the annual quality assurance reports. See Public Information Act Requests​ for prior year reports up to 2013. 

    ​Learn More About the HealthChoice MCO Auditors

    • Qlarant : Qlarant is a designated, independent External Quality Review Organization (EQRO) helping state agencies meet federal regulations for assessing Managed Care Organizations (MCOs).
    • MetaStar : As an independent, nonprofit quality improvement organization with 50 years of experience, MetaStar is dedicated to effecting positive change in health and health care to achieve optimal health for all.
    • Center for the Study of Services : Since 1998, CSS has worked with commercial, Medicaid, Medicare, and Qualified Health Plans as an approved CAHPS survey.​

    ​National Committee for Quality Assurance (NCQA) Health Plan Report Cards - Updated September 15, 2023

    The nine HealthChoice Medicaid MCOs are rated based on their combined HEDIS® and CAHPS® scores and NCQA Accreditation status. NCQA evaluates health plans on the quality of care patients receive, how happy patients are with their care, and health plans' efforts to keep improving. Ratings are updated annually in September.

    Medicaid HMO Plan Name

    Rating*

    Status

    Initial Accreditation

    Next Review Date

    Aetna Better Health of Maryland ★★★Accredited7/15/20205/19/2026
    CareFirst BlueCross BlueShield Community Health Plan of Maryland
    		★★★
    		Accredited12/17/20142/25/2025
    Jai Medical Systems
    		★★★★
    		Accredited9/15/20146/02/2026

    Kaiser Permanente

    		★★★★½
    		Accredited6/16/20165/27/2025
    Maryland Care Inc., d/b/a/ Maryland Physicians Care
    		★★★½​
    		Accredited8/22/201412/03/2024
    MedStar Family Choice, Inc. ★★★½
    		Accredited4/13/20091/16/2024
    Priority Partners MCO
    		★★★½Provisional**
    		5/17/20116/11/2024
    UnitedHealthcare of the Mid-Atlantic, Inc. - Medicaid★★★½Accredited3/3/201211/14/2023
    ​Wellpoint Maryland, Inc.​ ★★★½Accredited5/31/20131/07/2025

    * A health plan earns a rating from 1 to 5 stars based on quality (HEDIS®) and member experience (CAHPS®) scores.​

    ​**Under corrective action.

    QA Reports