MetroPlus Health ranked New York
City’s highest-rated health plan
TIMESLEDGER | QNS.COM | JAN. 22-JAN. 28, 2021 15
MetroPlus Health Plan
announced today that
it has been ranked
New York City’s
highest-rated health plan, according
to the New York State
Department of Health’s 2020
Consumer’s Guide to Medicaid
and Child Health Plus Managed
Care Plans in New York
City, the annual rating of managed
care plans on quality of
care delivered and members’
satisfaction with the care and
services they receive.
In New York City,
MetroPlusHealth earned 5
stars in a number of categories
and an overall rating of 5 stars,
the highest possible score. More
stars mean better healthcare.
“This outstanding result is
another proof of the superior
healthcare and coverage that
over 600,000 MetroPlusHealth
members receive and is reflective
of the excellent MetroPlusHealth
provider network that
puts quality healthcare - and
our members - first,” said Talya
Schwartz, MD, President and
CEO of MetroPlusHealth.
The health plan’s 2020 5-star
Overall Rating included 5 stars
in the clinical areas of Cardiovascular
Care, Diabetes Care,
Child and Adolescent Care, and
Adult Care.
The 2020 Consumer’s Guide
rates plans on 10 distinct measures
across three categories
– Preventive and Well-Care for
Adults and Children, Quality
of Care Provided to members
with Illnesses, and Patient
Satisfaction with Access and
Services – ultimately resulting
in an Overall Rating of 0 to 5
stars.
Ratings are based on a comparison
of plan rates to statewide
averages. Quality ratings
are from information submitted
by health plans. Patient
satisfaction ratings are from a
member survey conducted for
the Department of Health.
Results for measures involving
children and adolescents
are based on members of both
Medicaid and Child Health
Plus.
MetroPlusHealth attributes
its 5-star rating, a feat shared
by only one other plan in New
York City, to a number of factors,
including:
Hyperfocusing on Quality
Management
The MetroPlusHealth Quality
Management (QM) Department
has been at the forefront
of the health plan’s continuously
improving quality measure
scores. Providing convenient
access to care through community
events hosted by the
QM team, for example, helped
the Plan close gaps in care for
measures such as dental and
diabetic eye screenings, as well
as critical completion of flu
shots. MetroPlusHealth also increased
member and provider
education and participation in
closing gaps in care by modernizing
outreach through texting
programs and ongoing social
media postings. Yet the Plan
strategically retained some
traditional methods that work
well with their population,
such as mailings and personalized
telephonic outreach.
Rewarding Members for
Completing Healthy Activities
Another factor in increased
member satisfaction and quality
of care was the Plan’s Member
Rewards Program, launched in
2017. The Member Rewards Program
enables members to earn
points, redeemable for premium
items, by completing essential
healthcare services such as
well-visits, colonoscopies, medication
adherence, and more,
and healthy activities such as
the STEP-UP CHALLENGE,
where members track and
work to increase their physical
activity. Significant improvement
in member completion
of required health screenings
made a substantial impact on
the HEDIS/QARR measure
rates which directly affects the
overall rating.
Improving Communications
Between Departments
Enhanced communications
between departments was also
key to the Plan’s highest-rated
plan ranking. This includes
sharing responsibilities for
improvement interventions
between Quality Management,
Integrated Care Management,
Partnership in Care (for HIVpositive
and transgender members),
Behavioral Health, and
Pharmacy to name some of the
essential Medical Management
departments.
“Credit must go to the entire
team at MetroPlusHealth,” Dr.
Schwartz said. “Without the
dedication and hard work done
by each and every one of our
staff, as well as our partners
at NYC Health + Hospitals,
we would not have topped the
rankings this way,” she added.
“Our team is the reason we
earned our stars.”
About MetroPlus Health Plan
Since 1985, MetroPlus
Health Plan has built a reputation
for providing access to
affordable, quality health care
to residents across New York
City.
A wholly-owned subsidiary
of NYC Health + Hospitals, the
nation’s largest public health
system, MetroPlusHealth is the
plan of choice for over 600,000
New Yorkers and has a five-star
rating based on the State’s 2020
Consumer’s Guide to Medicaid
and Child Health Plus Managed
Care Plans in New York City.
The plan’s robust network
of primary care doctors and
specialists includes many independent
community providers.
Culturally sensitive, and fluent
in more than 40 languages,
MetroPlusHealth staff is as diverse
as the great city it serves.
For more information about
MetroPlusHealth plans, benefits,
and services, visit www.
metroplus.org and join the
conversation at facebook.com/
MetroPlusHealth/and twitter.
com/ @metroplushealth.
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