Blue Shield of California Promise Health Plan is celebrating another year of strong performance, earning 4 out of 5 stars in the 2026 National Committee for Quality Assurance’s (NCQA) Medicaid Health Plan Ratings for the third consecutive year.
Health plans are rated on a scale of 1 to 5 stars, with 5 stars representing the highest rating. The NCQA evaluates plans based on clinical quality and member experience using *HEDIS® and **CAHPS® data. Blue Shield Promise is one of only two Medi-Cal plans serving both Los Angeles and San Diego counties to receive a rating of 4 stars or higher in 2024, 2025, and 2026.
“Blue Shield Promise’s consistently strong ratings reflect the dedication of our care teams, provider partners, and community organizations to help members lead healthier lives,” said Kristen Cerf, president and CEO of Blue Shield Promise. “Earning a 4-star NCQA rating for the third consecutive year demonstrates our commitment to preventive care, quality improvement, and equitable access to services. Through timely screenings, immunizations, proactive care management, and personalized support, we’re helping members stay healthy and get the care they need.”
Strong performance in prevention and clinical quality
Blue Shield Promise’s highest scores were in two categories — treatment, and prevention and population health — emphasizing the health plan’s commitment to helping members access quality care, manage chronic conditions, and get the services they need to improve their overall health and well-being.
Blue Shield Promise earned the NCQA’s highest rating of 5 out of 5 stars across four treatment measures:
- Statin adherence for patients with cardiovascular disease
- Statin adherence for patients with diabetes
- Follow-up after emergency department visits for substance-use disorder
- Plan all-cause readmissions
These results reflect the health plan’s focus on medication adherence, timely member follow-up after care transitions, and strong coordination among hospitals, provider groups, and internal care teams.
Blue Shield Promise also earned the NCQA’s highest rating of 5 out of 5 stars in three prevention and population health measures:
These results highlight the nonprofit health plan’s efforts to better understand members’ needs, advance health equity, and improve care across the diverse communities it serves.
In addition, Blue Shield Promise received 4 out of 5 stars for prenatal, adolescent, and child immunizations, as well as breast cancer and cervical cancer screenings. These ratings reflect the health plan’s commitment to bringing care directly to members where they live and work through well-child visits, mobile mammogram screenings, and immunization programs that help remove barriers to care for families.
Blue Shield Promise also holds an NCQA Health Outcomes Accreditation, which recognizes organizations that use standardized data and measurement to identify their population’s unique health needs and address differences in health outcomes, experience, and access to care.
View Blue Shield Promise’s NCQA report card here, and/or learn more about NCQA ratings. Learn more about Blue Shield Promise here.
*HEDIS® Healthcare Effectiveness Data and Information Set
**CAHPS® Consumer Assessment of Healthcare Providers and Systems
Source: news.blueshieldca.com
