Nonprofit, community-based health plans receive highest marks in government program measuring quality
Washington (October 30, 2019) – The Alliance of Community Health Plans (ACHP) member organizations continue to lead the industry in high-value care delivery and exceptional customer service for Medicare Advantage beneficiaries, offering nine of the 20 total contracts to receive the top score of 5 stars in the Centers for Medicare and Medicaid Services’ (CMS) 2020 Star Quality Ratings. Overall, 39 Medicare Advantage contracts offered by ACHP members received 5, 4.5 and 4 stars in the ratings.
“These high ratings are a clear representation of the value ACHP members provide to the communities they serve,” said ACHP President & CEO Ceci Connolly. “ACHP’s integrated, provider-aligned health organizations continue to offer some of the highest quality coverage and care on the market – leading the industry to continually innovate to put patients at the center of their care.”
HealthPartners, Kaiser Permanente and Martin’s Point Health Care all earned the top score of 5 stars in the CMS ratings. Medicare Advantage is the only government health care program that measures and rewards high-quality, efficient, coordinated coverage and care, highlighting the superior coverage provided by ACHP members.
“At Martin’s Point, we’re committed to improving the health of our community and are incredibly proud to offer a 5-Star plan to our friends and neighbors here in Maine and New Hampshire,” said Dr. David Howes, President and CEO of Martin’s Point Health Care. “We share this recognition with over 50,000 Generations Advantage members who took an active role in their own health, our dedicated employees, and over 15,000 network providers who delivered excellent care to our members. Achieving this rating was truly a team effort and we could not have done this alone.”
ACHP member companies outperform other health plans in numerous domain areas, including managing chronic conditions; member experience with a plan, preventive measures including access to screenings, tests and vaccines; and drug safety and accuracy of pricing. ACHP members also led the industry in medication adherence for hypertension, diabetes and cholesterol; getting appointments, care and drugs quickly, and customer service.
In addition, ACHP members also received some of the highest NCQA quality ratings for their commercial product offerings for the 2019-2020 year. Capital District Physicians’ Health Plan (CDPHP) and Kaiser Foundation Health Plan of the Mid-Atlantic states offered three of the five commercial products in the country to earn the top rating of 5. Twenty commercial products operated by ACHP members received a rating of 4.5.
ACHP applauds these plans for their hard work and achievement. However, the highest quality Medicare Advantage plans in the nation are not able to receive and share with their seniors the full benefits of providing superior value due to a glitch in the Medicare Advantage quality payment program. ACHP calls on Congress to pass the bipartisan, bicameral Medicare Advantage Quality Payment Relief Act (HR 2131/S 1114) to ensure millions of seniors don’t miss out on enhanced health care services and reduced premiums.
The Alliance of Community Health Plans (ACHP) represents the nation’s top-performing non-profit health plans to improve affordability and outcomes in the health care system. ACHP member companies are provider-aligned health organizations that provide high-quality coverage and care to tens of millions of Americans. They are leading the industry in practical, proven reforms around primary care delivery, value-based payment and data-driven systems improvement.
ACHP advocates on behalf of its members and a unique approach to health care today, one that puts the patient at the center with health plans and clinical teams collaborating to improve health outcomes and reduce costs. Our advocacy focuses on providing policymakers with tested solutions being realized in communities nationwide and rooted in a model that is proven to deliver better value for patients, employers and taxpayers. Learn more at the ACHP website and follow us on Twitter for the latest health insights.