Nine Health Plan Alliance member plans achieved high quality ratings for 2017

Health Plan Alliance

11/28/2016

The Health Plan Alliance is proud of its health plan members who achieved high quality ratings from NCQA and the Centers for Medicare and Medicaid Services (CMS) this year.

 

NCQA 2016-2017 Health Insurance Plan Ratings 

In September 2016, NCQA released its ratings of more than 1,000 private, Medicare and Medicaid health insurance plans based on their combined HEDIS®, CAHPS® and NCQA Accreditation standards scores. Health Insurance Plan Ratings 2016–2017 uses the same Ratings methodology from 2015, which classifies plans into scores from 0-5 in 0.5 increments–-a system similar to CMS’ Five-Star Quality Rating System.

Eight Health Plan Alliance member plans were top performers, achieving ratings of 4.5 or 5.0 out of 5.0.  
These plans include:    

  • Geisinger (Commercial, Medicaid & Medicare)                                                   
  • Gundersen (Commerical & Medicare)                                                    
  • Health New England (Commercial, Medicaid & Medicare)                                                             
  • Neighborhood Health Plan (Commercial and Medicaid)                                                  
  • Network (Medicare)                                                      
  • Physicians Plus (Commercial)                                      
  • Scott & White (Commercial & Medicare)                                                               
  • Sharp (Commercial)                                                        
 

CMS Star Ratings

CMS publishes the Part C and D Star Ratings each year to: measure quality in Medicare Advantage (MA) and Prescription Drug Plans (PDPs or Part D plans), assist beneficiaries in finding the best plan for them, and determine MA Quality Bonus Payments. Moreover, the ratings support the efforts of CMS to improve the level of accountability for the care provided by physicians, hospitals, and other providers. Medicare Advantage with prescription drug coverage (MA-PD) contracts are rated on up to 44 unique quality and performance measures; MA-only contracts (without prescription drug coverage) are rated on up to 32 measures; and stand-alone PDP contracts are rated on up to 15 measures.

 
23 Medicare Advantage contracts received a 5 star rating for 2017, two of which were Health Plan Alliance member plans: Gunderson and Medical Associates.

Upcoming Star Rating Webinars

 

To support our health plan members’ efforts to achieve high quality ratings, the Health Plan Alliance has coordinated two Star Rating webinars for members:

  • Health Plan Alliance STAR Report Card
    December 2 | 1:30 – 3:00 p.m. CT | Presented by Altegra Health
    Learn how Alliance member health plans' performance compares to the national average (Part C & Part D). Registrants will receive the benchmark report as well as their plan-specific report.
    Register

  • 2017 Star Ratings: Using Emerging Trends to Flourish in the Future
    December 14 | 11:00 a.m. – 12:30 p.m. CT | Presented by Gorman Health Group
    Join Gorman Health Group Star Ratings and Risk Adjustment experts for a cross-functional review of the 2017 Star Ratings. Despite the many, often significant, changes amidst plan-specific 2017 Star Ratings, there is a surprising amount of stability in the 2017 Star Ratings.
    Register