Nonprofit, Community-based Health Plans Continue to Receive Highest Marks in Government Program Measuring Quality
Washington, D.C. (October 13, 2020)– The Alliance of Community Health Plans’ (ACHP) member organizations continue to lead the industry in high-value coverage and exceptional customer service for Medicare Advantage beneficiaries. Nearly half of the health plan contracts awarded 5 stars in the Centers for Medicare and Medicaid Services’ (CMS) 2021 Star Quality Ratings were offered by ACHP member companies. In a year in which star ratings became more strenuous than ever due to COVID-19, ACHP plans maintained and strengthened overall quality ratings, with 41 Medicare Advantage contracts receiving 5, 4.5 and 4 stars in the ratings.
“These high scores are a clear illustration of the top-quality coverage and care that ACHP members provide to individuals and families across the nation,” said ACHP President & CEO Ceci Connolly. “Even amidst a global pandemic that has struck more than 7.5 million Americans, when standards for star ratings are more vital than ever, these nonprofit, community health plans have remained resolute in their mission to deliver value and quality to those they serve.”
ACHP members Capital District Physicians’ Health Plan (CDPHP), Dean Health Plan, HealthPartners, Health Alliance, Kaiser Permanente, Martin’s Point Health Care and UPMC all offered contracts which 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.
“We are thrilled to once again be among the top-rated health plans in the nation,” said HealthPartners Executive Vice President & Chief Administrative Officer Jim Eppel. “Our 5-star rating is a testament to our team’s hard work and commitment to providing excellent quality and service to our members. Excellence in health care matters, and I’m proud to be part of an organization that is dedicated to making a true difference in the lives of those we serve.”
ACHP member companies outperform other health plans in numerous areas, including member experience with a plan; drug safety and accuracy of pricing; preventive measures, such as screening, tests, vaccines and managing chronic conditions. ACHP members also led the industry in medication adherence for hypertension and cholesterol; getting appointments and care quickly; care coordination; and getting needed prescription drugs.
“For more than 40 years, we have offered competitively priced, high-quality health insurance driven by providers with an emphasis on customer service,” said Dennis Hesch, president & CEO of Health Alliance, which received a 5-star rating for its Prescription Drug Plan. “The improvement we’ve seen in this key quality rating validates the priority we place on increasing the health of our local communities. Our efforts improve care coordination, increase access to care, deliver patient, member and provider satisfaction and achieve affordability.”
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.