Reddenda · the accountability index
PayerScore: how America's health plans treat providers
149 major payers graded 300 to 850 from the public federal IDR record, ranked by dispute volume. Lower is worse for providers. A modeled index and an opinion, from disclosed public data.
| PayerScore | Payer (national) | Providers win | Award vs QPA | Default | Disputes |
|---|---|---|---|---|---|
| 592 D | UnitedHealthcare | 83% | 310% | 10% | 796,348 |
| 425 F | Aetna | 92% | 472% | 31% | 376,089 |
| 531 D | Cigna | 81% | 377% | 24% | 263,599 |
| 518 D | Elevance/Anthem | 87% | 347% | 24% | 160,622 |
| 461 F | Centene | 90% | 260% | 47% | 20,410 |
| 721 B | Kaiser Permanente | 67% | 125% | 15% | 6,060 |
| 573 D | Anthem BCBS Ohio | 93% | 200% | 16% | 4,083 |
| 563 D | Humana | 79% | 300% | 26% | 2,645 |
| 506 D | Oscar Health | 92% | 439% | 11% | 2,237 |
| 300 F | EmblemHealth | 95% | 745% | 63% | 1,887 |
| 458 F | WebTPA | 84% | 680% | 16% | 1,533 |
| 485 F | GEHA | 90% | 423% | 21% | 1,161 |
| 616 C | Sierra Health and Life | 96% | 180% | 3% | 1,011 |
| 439 F | Anthem BCBS Missouri | 85% | 1,093% | 21% | 995 |
| 621 C | Molina Healthcare | 88% | 210% | 8% | 936 |
| 616 C | Capital Health Plan | 67% | 285% | 28% | 902 |
| 420 F | CareSource | 93% | 343% | 47% | 864 |
| 547 D | Providence Health Plan | 61% | 646% | 19% | 835 |
| 474 F | 90 Degree Benefits | 76% | 363% | 55% | 793 |
| 588 D | BCBS Texas | 77% | 239% | 29% | 705 |
| 440 F | MagnaCare | 79% | 2,415% | 28% | 654 |
| 488 F | Health First Health Plans | 77% | 617% | 16% | 571 |
| 403 F | Priority Health | 95% | 339% | 80% | 565 |
| 300 F | Health Advantage | 100% | 1,319% | 98% | 499 |
| 386 F | Sana Benefits | 75% | 676% | 49% | 475 |
| 458 F | Boon-Chapman | 78% | 625% | 24% | 446 |
| 300 F | Community Care | 95% | 994% | 91% | 415 |
| 562 D | Luminare Health | 81% | 273% | 27% | 395 |
| 375 F | EMI Health | 97% | 405% | 77% | 394 |
| 381 F | Centivo | 77% | 844% | 48% | 375 |
| 325 F | Friday Health Plans | 99% | 536% | 100% | 341 |
| 446 F | Trustmark | 85% | 365% | 46% | 302 |
| 653 C | SelectHealth | 69% | 211% | 22% | 295 |
| 449 F | Prominence Health Plan | 100% | 212% | 100% | 291 |
| 449 F | QualChoice | 91% | 851% | 11% | 290 |
| 439 F | Auxiant | 86% | 513% | 30% | 263 |
| 300 F | AmeriHealth | 96% | 1,272% | 54% | 261 |
| 509 D | Blue Shield of California | 77% | 1,825% | 10% | 247 |
| 717 B | Insurance Management Services | 49% | 125% | 37% | 242 |
| 539 D | Aither Health | 84% | 100% | 72% | 196 |
| 392 F | The Health Plan | 90% | 412% | 56% | 192 |
| 350 F | Gravie | 87% | 802% | 45% | 191 |
| 333 F | Healthfirst | 87% | 1,117% | 85% | 189 |
| 405 F | MVP Health Care | 89% | 1,624% | 26% | 186 |
| 300 F | Custom Design Benefits | 100% | 779% | 100% | 184 |
| 300 F | CHRISTUS Health Plan | 100% | 924% | 95% | 170 |
| 635 C | Medica | 64% | 343% | 19% | 169 |
| 300 F | Geisinger Health Plan | 99% | 938% | 100% | 152 |
| 320 F | HealthEZ | 90% | 708% | 51% | 141 |
| 302 F | Fidelis Care | 99% | 595% | 95% | 139 |
| 300 F | Arizona Complete Health | 97% | 964% | 74% | 135 |
| 300 F | The Loomis Company | 99% | 753% | 91% | 133 |
| 300 F | AmeriHealth Administrators | 99% | 1,972% | 82% | 128 |
| 379 F | Sentara Health Plans | 99% | 394% | 92% | 121 |
| 300 F | Community Health Group | 99% | 4,244% | 94% | 120 |
| 303 F | Ascension Personalized Care | 94% | 766% | 68% | 116 |
| 746 A | BCBS Louisiana | 53% | 310% | 3% | 114 |
| 369 F | HealthPartners | 95% | 421% | 60% | 112 |
| 371 F | Allied National | 100% | 416% | 100% | 109 |
| 310 F | American Medical Security | 93% | 1,197% | 54% | 96 |
| 481 F | HealthSmart | 85% | 240% | 76% | 96 |
| 567 D | Edison Health Solutions | 78% | 100% | 50% | 94 |
| 529 D | Consociate Health | 86% | 100% | 71% | 91 |
| 521 D | EBMS | 73% | 324% | 43% | 90 |
| 578 D | Entrust | 60% | 498% | 23% | 90 |
| 487 F | UniCare | 88% | 189% | 59% | 89 |
| 510 D | Trustmark Health Benefits | 76% | 280% | 48% | 85 |
| 519 D | AvMed | 79% | 214% | 56% | 85 |
| 422 F | Unified Group Services | 92% | 592% | 18% | 84 |
| 301 F | Populytics | 95% | 1,008% | 58% | 82 |
| 493 F | Vitori Health | 100% | 100% | 97% | 80 |
| 300 F | Johns Hopkins Health Plans | 100% | 1,236% | 98% | 80 |
| 595 D | Healthgram | 70% | 320% | 26% | 80 |
| 414 F | American Plan Administrators | 88% | 384% | 57% | 79 |
| 762 A | Imagine360 | 42% | 100% | 27% | 79 |
| 495 F | Zenith American Solutions | 62% | 835% | 34% | 78 |
| 469 F | Wellfleet | 89% | 489% | 20% | 75 |
| 439 F | Health Net | 96% | 239% | 58% | 74 |
| 491 F | PreferredOne | 75% | 434% | 37% | 74 |
| 333 F | Assured Benefits Administrators | 98% | 514% | 88% | 73 |
| 300 F | Total Plan Concepts | 97% | 859% | 62% | 73 |
| 619 C | BCBS New Mexico | 73% | 291% | 18% | 72 |
| 300 F | Keenan | 100% | 1,374% | 100% | 70 |
| 817 A | UHP Administrators | 21% | 56% | 10% | 67 |
| 541 D | SISCO | 73% | 213% | 72% | 67 |
| 364 F | Hometown Health | 94% | 444% | 55% | 66 |
| 544 D | University Health Alliance | 80% | 351% | 25% | 64 |
| 405 F | ASR Health Benefits | 100% | 326% | 98% | 61 |
| 300 F | Philadelphia American Life Insurance | 100% | 1,395% | 100% | 61 |
| 300 F | Nippon Life Benefits | 100% | 1,019% | 94% | 60 |
| 511 D | Fox Everett | 79% | 245% | 48% | 59 |
| 514 D | Fringe Benefit Group | 86% | 175% | 46% | 59 |
| 631 C | Sanford Health Plan | 68% | 227% | 29% | 58 |
| 522 D | Redirect Health | 88% | 100% | 80% | 58 |
| 351 F | AultCare | 100% | 467% | 91% | 57 |
| 514 D | Independent Health | 74% | 4,527% | 12% | 57 |
| 333 F | ConnectiCare | 87% | 1,197% | 80% | 56 |
| 383 F | Insurance Design Administrators | 99% | 386% | 84% | 53 |
| 580 D | Group & Pension Administrators | 72% | 218% | 39% | 53 |
| 381 F | Insurance Administrator of America | 91% | 1,621% | 31% | 53 |
| 685 B | Quartz Health | 47% | 100% | 57% | 51 |
| 477 F | Blue Advantage of Arkansas | 89% | 951% | 5% | 51 |
| 319 F | Community Health Choice | 99% | 551% | 53% | 50 |
| 311 F | Keystone Health Plan East | 93% | 9,015% | 55% | 50 |
| 406 F | Professional Benefit Administrators | 85% | 812% | 30% | 49 |
| 357 F | Secure Health | 100% | 451% | 100% | 48 |
| 300 F | Personal Choice | 98% | 9,623% | 92% | 48 |
| 447 F | Health New England | 84% | 337% | 54% | 47 |
| 300 F | Fabian & Byrn | 100% | 3,075% | 100% | 47 |
| 744 A | WellFirst Health | 55% | 250% | 8% | 46 |
| 447 F | Neighborhood Health Plan of RI | 80% | 2,778% | 25% | 46 |
| 300 F | Definity Health | 96% | 699% | 90% | 45 |
| 300 F | Univera Healthcare | 100% | 4,261% | 58% | 45 |
| 536 D | Clear Health Strategies | 97% | 375% | 5% | 45 |
| 617 C | BCBS Oklahoma | 52% | 363% | 37% | 45 |
| 545 D | Shannon Health Plan | 74% | 392% | 28% | 44 |
| 530 D | Wellnet Healthcare | 87% | 100% | 49% | 43 |
| 300 F | SIHO | 100% | 671% | 96% | 43 |
| 416 F | Performance Health | 75% | 936% | 41% | 43 |
| 712 B | BCBS South Carolina | 56% | 175% | 26% | 43 |
| 679 B | S&S Health | 52% | 90% | 69% | 42 |
| 458 F | BeneSys | 80% | 356% | 50% | 41 |
| 505 D | MedBen | 76% | 360% | 41% | 41 |
| 460 F | Alliant Health Plans | 83% | 376% | 43% | 40 |
| 427 F | SummaCare | 95% | 270% | 58% | 40 |
| 300 F | HMAA | 100% | 1,369% | 88% | 40 |
| 400 F | Group Benefit Services | 93% | 364% | 69% | 39 |
| 482 F | Merchants Benefit Administration | 100% | 127% | 100% | 39 |
| 300 F | MedStar Family Choice | 100% | 1,232% | 100% | 39 |
| 371 F | US Health and Life | 78% | 610% | 70% | 38 |
| 300 F | Health Cost Solutions | 100% | 2,350% | 100% | 38 |
| 493 F | Detego Health | 99% | 100% | 97% | 37 |
| 585 D | BCBS IL | 56% | 397% | 38% | 36 |
| 300 F | Benefit & Risk Management Services | 98% | 1,055% | 98% | 36 |
| 513 D | Banner Health | 87% | 222% | 41% | 36 |
| 300 F | Health Special Risk | 100% | 2,244% | 100% | 35 |
| 300 F | Freedom Life Insurance Company | 96% | 1,201% | 66% | 35 |
| 405 F | Blue Care Network | 99% | 328% | 79% | 35 |
| 344 F | Group Health Cooperative | 85% | 661% | 69% | 34 |
| 563 D | BCBS Arkansas | 85% | 148% | 36% | 33 |
| 371 F | Southwest Service Administrators | 83% | 551% | 50% | 33 |
| 382 F | Sharp Health Plan | 97% | 387% | 88% | 33 |
| 326 F | Maestro Health | 89% | 677% | 93% | 33 |
| 368 F | Physicians Health Plan | 85% | 536% | 52% | 32 |
| 461 F | Gilsbar | 88% | 260% | 58% | 32 |
| 668 C | BlueChoice | 40% | 144% | 63% | 32 |
| 409 F | Angle Health | 80% | 679% | 36% | 32 |
| 331 F | HealthNow New York | 88% | 1,129% | 54% | 30 |
| 322 F | PHP TPA Services | 97% | 1,052% | 43% | 30 |
Why lower is worse
A payer scores low when providers win most of their federal IDR disputes against it, the winning awards land far above the payer's own qualifying payment amount, and the payer defaults or sees its winning awards land far above its own QPA most often. High-scoring payers settle fairer and default less. Every grade links to the underlying federal record.
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About this grade. PayerScore is a modeled index and an opinion derived from disclosed public data, not a statement of fact about the payer's conduct. It is computed by deterministic method (v1.0.0) from public federal IDR dispute records (CMS Public Use File) and documented public rate positions vs the local peer median. These are federal independent-dispute-resolution records, not court judgments or litigation. Figures are modeled, not guaranteed. See the methodology. A payer may request a correction at corrections@reddenda.com.