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National Committee for Quality Assurance (NCQA) is a widely recognized, evidence-based program dedicated to quality assurance and patient safety. Achieving NCQA Accreditation has become a gold standard for healthcare organizations striving for excellence and alignment with both state and federal regulations. Oscar is proud to have NCQA Accreditation status for all of our operating state health plans and additional Accreditation programs dedicated to Utilizament management (UM), Credentialing (CR), Provider Network (NET) and Health Equity (HEA).
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Health Plan Accreditations

Oscar Management Corporation

NCQA Utilization Management

Utilization Management Accreditation

The NCQA Utilization Management Accreditation provides a framework to ensure: fair and timely utilization evaluations using objective, evidence-based criteria, collection and use of relevant clinical information to make utilization management decisions, qualified health professionals that assess requests and utilization management decisions, and alignment with state requirements.

Provider Network Accreditation

Provider Network Accreditation

The NCQA Provider Network Accreditation helps to maintain a high-quality network for members and ensures that organizations have the processes and procedures to effectively manage access to care and member experience while ensuring that practitioners and providers are appropriately credentialed.

Credentialing Accreditation

Credentialing Accreditation

The NCQA Credentialing Accreditation is an essential safety component of the health care system. Health care organizations must establish the qualifications of their licensed medical professionals by assessing their background and legitimacy to provide care. This Accreditation focuses on consumer protection and customer service improvement. It provides a framework for organizations to implement industry best practices that help them efficiently credential and re-credential health care professionals.

Health Equity Accreditation

Health Equity Accreditation

The NCQA Health Equity Accreditation Program focuses on: building a culture that supports the organization’s health equity work; data that help the organization create and offer language services and provider networks mindful of individuals’ cultural and linguistic needs. The health care industry is reevaluating how to improve health equity across all populations. Oscar is committed to reducing health disparities in underserved populations so that it results in better health outcomes, but also reduces overall treatment costs.

STAR Rating Year 2024

STAR Ratings

CMS uses a star rating between 1 and 5 (5 is the highest) to demonstrate how a health plan compares to other plans on HealthCare.gov. Health plans receive an Overall Rating which accounts for three categories: Medical Care, Member Experience, and Plan Administration.
Star rating

Final Rating (STAR Year 2024)

  • Arizona: 4
    • Florida: 3
      • Georgia: 2
        • Iowa: 3
          • Missouri: 3
            • New Jersey: 3
              • New York: 4
                • Oklahoma: 1
                  • Ohio - Columbus: 3
                    • Ohio - Cleveland: 5
                      • Pennsylvania: 3
                        • Tennessee: 3
                          • Texas: 2