October 21, 2013
CONTACT: Rachel Schwartz
WASHINGTON, D.C. —Seven members of the Alliance of Community Health Plans (ACHP) received 5 stars from the Centers for Medicare and Medicaid Services (CMS) for their combined Medicare Advantage and prescription drug (Part D) programs, the highest score awarded to health plans participating in the Medicare program. Only 11 plans (contracts) in the country received the 5-star rating for their combined Medicare Advantage and Part D offerings. An additional 2 plans offered by ACHP members received 5 stars for their stand-alone Medicare plans (Part C).
Overall, 33 Medicare plans (contracts) operated by ACHP members received 5, 4.5 and 4 stars in the combined 2014 Medicare Advantage and Medicare Part D Star Ratings released October 21, 2013 by CMS. Eight ACHP members increased their star ratings from last year.
“The star ratings are an important tool for consumers looking for the best health care for their money. The superior performance of ACHP members is a direct reflection of our long-standing commitment to delivering affordable, high-quality coverage to our patients and our communities,” said Patricia Smith, ACHP president and CEO. “By providing effective, high quality care and excellent service to millions of Medicare beneficiaries, ACHP members are also making sure the federal government – and American taxpayers – are getting the value and accountability they demand from Medicare Advantage plans.”
“CMS raises the bar on its rigorous star criteria each year, so it is a significant accomplishment for the health plans to maintain and improve their star ratings. The results of ACHP plans demonstrate the value of our Medicare Advantage products and also provide assurance to Medicare beneficiaries on the quality and value of their coverage,” said ACHP Board Chair Michael W. Cropp, M.D., president and CEO of Independent Health in Buffalo, New York.
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’ star rating system considers over 50 quality measures, such as lowering hospital readmissions, diabetes management and ensuring that members receive recommended cancer screenings.
Quality incentive payments are improving quality across the board, with overall scores increasing in all plans. Seven ACHP members increased their quality score from last year’s ratings. ACHP member organizations 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 (HMO)
Kaiser Permanente California
Kaiser Permanente Colorado
Kaiser Permanente Georgia
Kaiser Permanente Hawaii
Kaiser Permanente Mid-Atlantic
Kaiser Permanente Northwest
ACHP plans receiving 5 stars for their stand-alone Medicare (Part C) plans
Dean Health Plan
ACHP plans receiving 4.5 stars for their combined Medicare Advantage and Part D plans
Capital Health Plan
Capital District Physicians’ Health Plan (HMO)
Capital District Physicians’ Health Plan (PPO)
Fallon Community Health Plan (HMO)
Geisinger Health Plan (HMO)
Geisinger Health Plan (PPO)
HealthPartners – Group Health Plan
Independent Health (HMO)
Independent Health (PPO)
Martin’s Point Health Care
Priority Health (HMO)
Priority Health (PPO)
Scott & White Health Plan
Security Health Plan
Tufts Health Plan
ACHP is a national leadership organization that brings together innovative health plans and provider groups that are among America’s best at delivering affordable, high-quality coverage and care in their communities. 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 23 organizations focus on improving the health of the communities they serve and are on the leading edge of patient care coordination, patient-centered medical homes, accountable health care delivery, use of information technology and other innovations leading to improvements in affordability and the quality of care. To learn more about ACHP, go to www.achp.org.