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MCS’s Medicare Advantage Plan lands 4.5-star rating from CMS regulatory agency

MCS Advantage Inc., a healthcare company offering Medicare Advantage (MA) insurance coverage for seniors, announced that its MCS Classicare (HMO) health plan received from the Centers for Medicare & Medicaid Services (CMS) an overall 4.5-star rating out of 5 stars, for all its Medicare Advantage products for 2022.

The plan also achieved a 5-star rating on customer service, the only plan in Puerto Rico to do so this year, and a 5-star rating on Part D for two consecutive years, the provider confirmed.

As of September, the 1st, 2021 more than 185,800 members were enrolled in all MCS Classicare plans in Puerto Rico.

For the last two years, MCS Classicare has been a 4-star rated plan focused on continuously improving the benefits and services it provides its beneficiaries and constituents altogether. Today, MCS Classicare’s entire membership portfolio is enrolled in 4.5-star out of 5 stars rated MA products for 2022.

Four stars or higher ratings ensure that beneficiaries receive the highest quality services and benefits from their MA plan.

“MCS Classicare’s strong Medicare star ratings, in an increasingly competitive industry and challenging regulatory environment, certainly reaffirms our position as a leader in the local market and reflect our mission to improving our members’ health by working more closely with the doctors and providers to enhance care coordination while improving their service experience,” said COO Roberto Torres.

The CMS evaluation system is based on a total of 40 quality metrics. Within the quality metrics are included many elements that play an important role in improving service experience such as expanding the access to preventative services, improving chronic disease care and the operational efficiency of the health plan.

The evaluation, which focuses on the quality of service received by patients, include their interactions with the different elements of the healthcare system, including the service provided by health plans, as well as doctors, nurses and personnel at hospitals, private medical offices, and other healthcare facilities they visit.

“Our 4.5-star rated out of 5 stars for MA products by 2022 is the result of a successful joint effort carried out by our excellent team of employees in coordination with our providers and business partners,” said María de Lourdes Ramón, senior vice president of quality for MCS.

“For instance, this joint effort has led to the creation of our reputable Care Management programs, which have rendered excellent results for our members as they are centered on patient outcomes such as reducing hospital readmissions and improving preventive care. Our members also play a key role here by taking preventive care of their health,” she said.

“Our MCS Classicare members actively participating in our innovative Care Management programs are, indeed, those with the lowest readmission rates, less visits to emergency rooms and the lower development of complications. So, with this 4.5-star rating we are now reaping the fruits of our efforts, and reaffirming we are on the right track toward improving our members’ health and quality of life,” Ramón said.

MCS Classicare serves Medicare beneficiaries island wide with Medicare Advantage plans and Medicare prescription drug plans, available for selection during the Medicare Annual Open Enrollment period, which starts on Oct. 15 and runs through Dec. 7. Enrollment will be effective Jan. 1, 2022.

CMS’s Medicare Star Rating System ranks the performance and quality of Medicare Advantage plans to help Medicare beneficiaries do an objective search by comparing all Medicare Advantage plans available in their area.

Star ratings are calculated each year using a scale of one to five stars (with five being the best) and change from one year to the next, depending on how the plan performs.

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This story was written by our staff based on a press release.

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