Neighborhood Health Plan Earned 4.5 Star Rating
Rhode Island Medicaid providers now face a new benchmark as the NCQA updates its quality performance rankings.
Updated on Sept. 21, 2026 in Healthcare
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The National Committee for Quality Assurance awarded Neighborhood Health Plan of Rhode Island 4.5 stars for its 2026 Medicaid offerings. This rating establishes a new quality benchmark for local managed care organizations operating within the state.
Why it matters
Quality ratings serve as critical indicators of operational efficiency and patient outcomes, influencing plan competitiveness and long-term viability in the Medicaid market. These scores reflect how well organizations manage clinical care and member experiences.
The NCQA awarded Neighborhood Health Plan a 4.5-star rating for its 2026 Medicaid plan, outpacing the 4-star rating earned by UnitedHealthcare of New England and the 3.5-star mark for Blue Cross & Blue Shield of Rhode Island. The provider has held accreditation for 23 years.
The players
Neighborhood Health Plan of Rhode Island
A non-profit health insurance provider founded in 1993 that serves a significant portion of the Rhode Island Medicaid market.
National Committee for Quality Assurance
A Washington, D.C.-based non-profit organization that establishes the standards and accreditation protocols for U.S. health care plans.
Peter Marino
The CEO of Neighborhood Health Plan who oversees the company's operational strategy and quality improvement initiatives.
UnitedHealthcare of New England
A regional subsidiary of the nation's largest health insurer, providing managed care and administrative services across the region.
Blue Cross & Blue Shield of Rhode Island
A major health insurance carrier providing a range of medical coverage plans to employers and individuals across Rhode Island.
The details
Ratings are determined by a weighted average of clinical measures, patient experience, health outcomes, and organizational accreditation standards. This methodology rewards plans that effectively integrate provider networks with preventive care protocols to improve patient health. Organizations must demonstrate consistent performance across these categories to maintain or improve their standing in the annual review.
Timeline
1993: Neighborhood Health Plan was founded.
2003: The insurer began its 23-year accreditation period.
September 16, 2026: CEO Peter Marino announced the NCQA rating.
2026: The 4.5 star Medicaid health plan rating is active.
Market Landscape
The latest rankings reflect the ongoing implementation of the National Committee for Quality Assurance Health Plan Accreditation standards across the regional insurance sector. These metrics provide the primary competitive barometer for health plans as they vie for Medicaid contract stability.
Operators in the healthcare space should monitor how these ratings influence state contracting and member retention shifts. Assess your own internal quality tracking against the weighted clinical and outcome metrics prioritized by the NCQA to ensure alignment with state expectations.
The takeaway
High-performing health plans leverage multi-year accreditation cycles to signal operational reliability to both regulators and patients. Review your organization's most recent clinical outcome reports to identify which specific performance gaps might be impacting your next cycle of accreditation.
Further reading
For more on industry benchmarks, read the latest Healthcare analysis.
Source note: This article includes information reported by Providence Business News.
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