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Published: Tue, October 13, 2015
Economy | By Melissa Porter

Fidelis Care Achieves 4-Star Medicare Rating


BlueCross BlueShield of Tennessee's Medicare Advantage PPO product secured a 4-STAR quality rating from the Centers for Medicare and Medicaid Services (CMS). "We, along with our provider partners, have made a conscious decision to invest in quality for our members, and we are being rewarded for our efforts".

The overall rating provides a way for Medicare beneficiaries, their families, and caregivers to compare performance among several plans. CMS' methodological changes and improvements among all Medicare plans continue to raise the bar on the level of performance required to achieve 5 stars.

UPMC, for example, is using telehealth in its RAVEN (Reduce Avoidable hospitalizations using Evidence-based interventions in Nursing facilities in western Pennsylvania) program, which connects participating nursing facilities to the Western PA Health Information Exchange.

"We everyone of them are incredibly pleased with our Content management system history due to the fact that it vindicates Security Health Plan's resolve to if the high quality of coverage and protection our users deserve", said Julie Brussow, ceo at Security Health Plan.

In addition to recognition by CMS, Kaiser Permanente Medicare plans' quality excellence was recently highlighted by the National Committee for Quality Assurance report, "NCQA's Health Insurance Plan Rankings 2015-16".

Fidelis Care serves more than 42,000 Medicare Advantage members. "Our physicians, nurses and staff provide medical care that is personalized, technologically advanced and closely coordinated across both inpatient and outpatient settings". A company-wide initiative focused on member and provider engagement, helped ensure that members took advantage of the preventive care and screening available to better manage their health and conditions.

 

The Centers for Medicare and Medicaid Services advises all Medicare beneficiaries to review their plans to make sure their needs are met the following year. Star Ratings are calculated each year and may change from one year to the next.

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