Tufts Medicare health plans earn high marks

WATERTOWN – Tufts Health Plan has earned 4.5 Stars out of a possible 5 for its Tufts Medicare Preferred HMO and Senior Care Options plans from the Center for Medicare and Medicaid Services as part of its annual Star ratings for 2015.
The Tufts Medicare Preferred HMO, a Medicare Advantage plan, has received a 4.5 Star rating from CMS for five consecutive years, the company said.

“We work in collaboration with our contracted physician groups to continually improve the service and care our members receive. Earning a high rating in the Star program reflects our efforts and the value we place on quality, member satisfaction and outcomes for our members,” Patty Blake, president, senior products, said in a statement.

CMS calculates Star ratings from 1 to 5 (with 5 being the best) based on quality and performance for Medicare health and drug plans to help beneficiaries, their families and caregivers compare plans.

Ratings are given for quality measures across five categories for plans covering health services: staying healthy, managing chronic conditions, member satisfaction, customer service and pharmacy services.
For plans covering drug services, the quality measures fall into four categories: drug plan customer service, member complaints and changes in the drug plan’s performance, member experience with plan’s drug services, and drug safety and accuracy of drug pricing.
Other local plans also were included in the report by CMS.
Blue Cross & Blue Shield of Rhode Island received an overall 4 rating, while Neighborhood Health Plan of Rhode Island and Tufts Health Plan – Network Health were too new to be measured.

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Stacy Paterno, assistant vice president, public affairs at Blue Cross & Blue Shield of Rhode Island, said the company “is proud of its continued success in achieving a 4 Star rating from the Centers for Medicare & Medicaid Services for all BlueCHiP for Medicare Advantage plans and is pleased to receive a 4.5 Star rating for its Medicare Part D plan.”

“BCBSRI’s overall unrounded result for the 2015 rating period improved by 0.351 Stars over the previous period, and we remain committed to continuing to provide high quality Medicare Advantage options to our members,” she said.

UnitedHealthcare said it has a variety of Medicare contracts in Massachusetts and Rhode Island, which range from 3.5 to 4.5 Stars for 2015.

“UnitedHealthcare continues to strive to make year-over-year improvement in our quality performance and in the health care experience for millions of Medicare beneficiaries. As we work to improve our Star Ratings, our portfolio of Medicare plans will continue to offer area beneficiaries the choice and value that have made UnitedHealthcare a market leader in Medicare,” a statement from the company reads.

Tufts Medicare Preferred HMO and Senior Care Options plans received 5 Stars in 25 out of 41 measures including:

  • Member satisfaction measures such as overall rating of health plan, rating of health care quality and overall rating of drug plan
  • Health measures such as controlling blood pressure, colorectal screening and cholesterol screening
  • Service measures such as customer service, low volume of complaints and low volume of members choosing to leave plan

The rating follows the recent ranking of Tufts Health Plan as the No. 1 private health insurance plan and the No. 1 Medicaid health insurance plan, known as Network Health, by the National Committee of Quality Assurance’s Health Insurance Plan Rankings 2014-2015.

Tufts Health Plan serves members in Massachusetts and Rhode Island.

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