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COURIER L 10 IFE, JAN. 29-FEB. 4, 2021
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MetroPlus Health ranked NY’s
highest-rated health plan
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 refl ective
of the excellent MetroPlusHealth provider
network that puts quality healthcare
– and our members – fi rst,” 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.
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 fl u
shots.
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 like
dental and diabetic eye screenings, as
well as critical completion of fl u shots.
MetroPlusHealth also increased
member and provider education and
participation in closing gaps in care by
modernizing outreach through texting
programs and social media postings.
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.
Signifi cant 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
HIV-positive and transgender members),
Behavioral Health, and Pharmacy
to name some of the essential Medical
Management departments.
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 fi ve-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.
For more information about
MetroPlusHealth plans, benefi ts, and
services, visit www.metroplus.org and
join the conversation at facebook.com/
MetroPlusHealth/and twitter.com/ @
metroplushealth.
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