MetroPlus Health ranked New
York’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
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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. Results for measures
involving children and adolescents
are based on members of both Medicaid
and Child Health Plus. The complete
2020 Consumer’s Guide can be
found here.
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.
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 HIV-positive 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 fi vestar
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 fl uent in
more than 40 languages, MetroPlusHealth
staff is as diverse as the great
city it serves.
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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