(GRAND RAPIDS, Mich., Oct. 7, 2022) Priority Health has once again been nationally recognized for the quality of its Medicare Advantage plans through the 2023 Medicare Star Ratings released by the Centers for Medicare and Medicaid Services (CMS), a part of the U.S. Department of Health and Human Services.
Priority Health’s HMO Medicare Advantage product received 5 stars – the highest possible rating from CMS; only 57 out of 507 plans nationwide earned 5 stars.
“These ratings show our commitment to ensuring our members get the care they need at an affordable cost,” said Joyce Chan Russell, senior vice president of government markets at Priority Health. “As a result of these ratings, Priority Health is a leader in quality and will continue offering better benefits and lower premiums for Medicare members.”
CMS also awarded Priority Health’s other Medicare Advantage plans an additional half star above the previous year – the PPO plan received 4.5 stars and the Dual-eligible Special Needs Plan received 4 stars.
Star Ratings are available each fall and given on a contract-by-contract basis. CMS awards quality bonus payments (QBPs) to highly rated Medicare plans. A health plan’s overall Star Rating is based on a weighted average of the plan’s performance on measures across these main categories:
- Staying healthy: Are the plan’s members getting their preventive care (annual screenings, tests and vaccines) and other checkups that help them stay healthy?
- Managing chronic (long-term) conditions: This measurement is based on how often plan members with chronic conditions like diabetes, hypertension or high cholesterol, get tests and treatments that help them manage their condition.
- Member experience with the health plan: Through annual surveys, CMS will ask members to rate their satisfaction with their plan. This category also reflects the percentage of members who voluntarily choose to leave the plan.
- Member complaints and changes in the health plan’s performance: Includes how often CMS found problems with the plan and how often members reported complaints about the plan. This also measures if a plan’s performance has improved over time.
- Health plan customer service: Focuses on the plan’s approach to member appeals and how well and timely those appeals were handled.
- Drug safety and accuracy of drug pricing: Reports on the accuracy of the plan’s pricing information and how often members with certain medical conditions are prescribed drugs in a way that is safe and clinically recommended for their condition.
CMS ratings were released ahead of annual enrollment period for Medicare which takes place October 15-December 7. Priority Health has had a successful year in quality and performance ratings across all plans; find more information at priorityhealth.com.
