ACHP Members Rated Among Top Medicare Plans in the Country

Seven members of the Alliance of Community Health Plans (ACHP) earned 5 Stars from the Centers for Medicare and Medicaid Services (CMS), the highest score awarded to health plans participating in the Medicare program. Only 11 plans (contracts) in the country received this rating. Overall, 28 Medicare plans (contracts) operated by ACHP members received 5, 4.5 and 4 Stars in the Star Ratings released yesterday by CMS; plans offer combined Medicare Advantage (Part C) and prescription drug (Part D) coverage. Additionally, one plan offered by an ACHP member received 5 stars for its stand-alone Medicare plan (Part C). These high-rated plans from ACHP member organizations are available in 18 states and the District of Columbia.

“The Medicare star ratings are an important reflection of the rigorous standards placed on health plans to deliver the highest quality care to the Medicare members that count on them for coverage,” says Patrick Courneya, M.D., executive vice president and chief medical officer for Kaiser Foundation Hospitals and Kaiser Foundation Health Plan. “We are proud to have 5-star plans in our California, Northwest, Hawaii, Colorado and Mid-Atlantic States regions, and a 4.5 star plan in our Georgia region. Our high ratings are achieved through the dedication of our physicians and care teams to deliver proactive care to detect, prevent and treat chronic conditions and diseases through a patient-centered approach.” Read Kaiser Permanente’s press release here.

“The value of the star ratings is growing as more and more beneficiaries are enrolling in high quality MA plans,” says Patricia Smith, ACHP president and CEO. “The superior performance of ACHP member organizations – repeated year after year – is a direct reflection of our long-standing commitment to delivering affordable, high-quality coverage and care to our customers and our communities. Many ACHP members, including Kaiser Permanente, Group Health Cooperative in Seattle, Washington, and Dean Health Plan in Madison, Wisconsin, have received 5-star ratings several years in a row.”

Martin’s Point Health Care of Portland, Maine, was also among the seven ACHP plans receiving 5 stars this year. “High quality primary care has been a hallmark of health care in Maine for years and this star rating puts that work into a national context,” said President and CEO David Howes, M.D. “We’re honored to be among some of the most respected organizations in the country, and we’ll keep trying to make our program even better.”Congress has demanded greater value by creating quality incentive payments in Medicare Advantage to promote health plan efforts to achieve high clinical quality and consumer satisfaction, as well as improved patient outcomes. CMS’s star rating system considers 46 quality measures, including lowering hospital readmissions, diabetes management and ensuring that members receive recommended cancer screenings.The quality incentive payments are improving quality across the board, with overall scores increasing in all plans. ACHP members promote evidence-based practice, engage patients in their care and align incentives with providers to ensure that Medicare patients get the right care when and where they need it.Visit ACHP.org for more information, including a table of ACHP member plans’ rankings, further analysis of the ratings and rankings, and member stories.

Plan performance star ratings are assessed each year and may change from one year to the next.

ACHP plans receiving 5 stars for their combined Medicare Advantage and Part D plans:

  • Group Health Cooperative
  • Kaiser Permanente California
  • Kaiser Permanente Colorado
  • Kaiser Permanente Hawaii
  • Kaiser Permanente Mid-Atlantic
  • Kaiser Permanente Northwest
  • Martin’s Point Health Care

 

ACHP plan receiving 5 stars for its stand-alone Medicare (Part C) plan:

  • Dean Health Plan

About ACHP

The Alliance of Community Health Plans (ACHP) is a national leadership organization bringing together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care. The community based and regional health plans and provider organizations from across the country that make up ACHP’s membership provide coverage and care for approximately 16 million Americans. These 22 organizations focus on improving the health of the communities they serve and are on the leading edge of innovations in affordability and the quality of care, including patient care coordination, patient-centered medical homes, accountable health care delivery and use of information technology. For more information visit www.achp.org.