Health
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 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.
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’shighestrated
plan ranking. This includes sharing responsibilities
for improvementinterventions
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.
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Schneps Media January 21, 2021 17