Accomplishments

Neighborhood is one of the top rated Medicaid health plans in America.

Neighborhood is fully accredited with the National Committee for Quality Assurance (NCQA).

  • Neighborhood is one of the highest-rated health insurance plan in the nation based on NCQA’s Medicaid Health Insurance Plan Ratings (2015-2019)
  • Neighborhood first earned NCQA’s “Excellent” Accreditation status in 2001 for its Medicaid product and has retained that distinction for 19 years. In 2020, NCQA removed “Excellent” status and the highest status a Plan can achieve is “Accredited.
  • In 2014, Neighborhood achieved the “Accredited” status–the highest possible status–from NCQA for its commercial marketplace product offered through HealthSourceRI, and retained that through the 2017 accreditation cycle.
  • In 2015, Rhode Island ranked No. 1 in children’s Medicaid health care quality, according to a report from the Centers for Medicare and Medicaid Services. Neighborhood serves 66 percent of these children.

Neighborhood is a leader in health care innovation.

We are always seeking ways to improve health care delivery to make access easier and outcomes better. Our vision is for everyone in Rhode Island to have comprehensive coverage and access to high-quality health care. We work on this every single day. Here are some highlights of how we’re innovating in health care.

  • Neighborhood formed and supported five Medicaid Accountable Entity (AE) organizations statewide, covering more than 72 percent of all Neighborhood Medicaid members (as of October 2017). AEs promote enhanced care management, leading to more efficient health care and overall savings of taxpayer dollars.
  • During 2015 to 2018, Neighborhood maintained less than 10 percent administrative fees rate with at least 90 percent of revenue applied directly to member services.
  • Neighborhood was named 2017 “Best Place to Work” by Providence Business News in the Large Employer (150-499 employees) category.
  • Working with providers and members, Neighborhood members maintain a generic drug utilization rate of 80 to 89 percent (varies by population served).
  • Neighborhood created new behavioral health services with provider partners, reducing inpatient hospital utilization by 25 percent.
  • In 2013, Neighborhood launched Health@Home, a home-based care program for highly complex and costly members. From 2013 to 2016, reduced emergency room visits by 43 percent and hospital inpatient days by 29 percent, collectively saving more than $2 million per year.
  • In 1999, Neighborhood founded the Association of Community Affiliated Plans, an organization of independent, non-profit community-based plans dedicated to Medicaid Managed Care.
  • Neighborhood was one of two health plans selected by Robert Wood Johnson Foundation to address racial and ethnic health disparities through medical interpreter reimbursements, standards and training through the Hablamos Juntos grant.
  • Selected by Center for Health Care Strategies for funding to assess how to incorporate adults with developmental disabilities into Medicaid managed care, to improve access to preventive care services for adolescents, and to help reduce health disparities among pregnant Hispanic women.
  • Awarded Centers for Disease Control grant, Beating Asthma, to develop a community based asthma program.