A Trusted Name In The Community For Over 50 Years
CHERICO REAL ESTATE
CHERICO REAL ESTATE
ONX, NY
BRONX TIMES REPORTER, J BTR AN. 22-28, 2021 37
Plan awarded coveted 5-Star rating
by its membership in annual survey of
New York City’s state-sponsored health
insurance plans.
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. 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.
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.
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. “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.”
MetroPlusHEALTH Highest-Ranked
James E. MaQuade, Owner
Family Owned & Operated for over 60 years
3535 East Tremont Avenue
Bronx, New York
718-792-0270
www.schuylerhill.com
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