Triple-S Advantage’s HMO contract (H5774) received a 4-star rating from the Centers for Medicare and Medicaid Services (CMS) 5-star rating system as a result of the company’s close collaboration with its healthcare providers and business partners to provide quality services to the Medicare Advantage population, the insurance provider announced Monday.
In addition, the company’s strategies and close partnership with its pharmacy benefit manager (PBM) resulted in an increase in the rating to 5 out of 5 stars on its HMO (H5774) Part D prescription drug coverage and 4.5 out of 5 stars on its PPO plans’ (H4005) Part D prescription drug coverage.
“We’re very proud of this acknowledgement, which recognizes the extraordinary effort of our employees working in unison with our medical groups to increase the rating of our HMO contract from 3 to 4 stars on the CMS 5-star rating system. This achievement is part of Triple-S Advantage’s transformation strategy, which validates the company’s commitment to our members,” said Madeline Hernández-Urquiza, president of Triple-S Advantage and Triple-S Salud.
The CMS Star Rating System reflects the quality of care received by plan members, with emphasis on preventive medicine and members’ satisfaction with their Medicare Advantage plan. Annually, CMS collects data and, based on it, awards each plan a rating from 1 to 5, with 5 representing the highest possible rating.
Hernández-Urquiza explained that the company has continued to innovate in care models and investing in technology to strengthen the support platform for its medical groups, allowing them to continue providing quality services to its plan members.
Medicare beneficiaries can select a new Medicare Advantage plan between October and December of 2016.
“Being the only plan in Puerto Rico to have achieved a 5-star rating in Part D of our HMO (H5774) contract, which also achieved an overall 4-star rating, we are confident about our offer this year, with the backing of our campaign,” said Hernández-Urquiza.