Santa Clara Family Health Plan earns elevated rating from NCQA

29.10.25 21:00 Uhr

Local health plan achievement demonstrates commitment to delivering access to high quality care.

SAN JOSÉ, Calif., Oct. 29, 2025 /PRNewswire/ -- Santa Clara Family Health Plan (SCFHP) is proud to share its 2025 Medicaid Health Plan Ratings from the National Committee for Quality Assurance (NCQA). The SCFHP Medi-Cal plan earned an overall rating of 4 out of 5, up from last year's 3.5 out of 5 rating. Only eight out of 24 Medi-Cal plans in California achieved a rating of 4 or higher.

The SCFHP Medi-Cal plan earned an overall rating of 4 out of 5, up from last year’s 3.5 out of 5 rating.

"We are grateful to our dedicated staff and health care partners whose hard work and collaboration made this achievement possible," said Christine M. Tomcala, Chief Executive Officer of SCFHP. "The improvement of our rating is no small feat. These results reflect our team's ongoing commitment to quality care and supporting our members in staying healthy."

NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. The NCQA website (www.ncqa.org) contains information to help consumers, employers, and others make informed health care choices.

NCQA's Medicaid Health Plan Ratings are based on a health plan's combined HEDIS® and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) scores and NCQA Accreditation status. Health plans are evaluated on the quality of care patients receive, how happy patients are with their care, and the health plan's efforts to keep improving.

"I'm especially proud that Santa Clara Family Health Plan earned a 4.5 out of 5 in the prevention and population composite category of the assessment," said Ria Paul, MD, Chief Medical Officer of SCFHP. "Ensuring our members have access to timely preventive care and immunizations is critical to maintaining their health, and to avoiding more costly care down the line."

About Santa Clara Family Health Plan
Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to creating opportunities for better health and wellness for all. In partnership with providers and community organizations since 1997, SCFHP works to ensure everyone in Santa Clara County has access to equitable, high-quality health care. With a strong commitment to integrity, outstanding service, and support for our community, SCFHP serves more than 295,000 people through our Medi-Cal and Medicare health care plans. For more information, visit www.scfhp.com.

SCFHP logo (PRNewsfoto/Santa Clara Family Health Plan)

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SOURCE Santa Clara Family Health Plan