Triple-S Management Corp. announced that its Triple-S Advantage 2020 Care Coordination Medicare Advantage HMO contract (H5774) will remain among Medicare Advantage plans with at least a 4-star rating — out of a maximum rating of 5 stars from the Centers for Medicare and Medicaid Services — for a fourth consecutive year.
“Only one-in-three Medicare Advantage plans are four stars or higher in the United States,” said Madeline Hernández-Urquiza, president of Triple-S Advantage Inc.
“This is the fourth straight year we have earned a 4-star rating or higher. While we’re pleased with this achievement, we continue strengthening our efforts to help our members live healthier and have an excellent overall experience with Triple-S, particularly when it comes to service, treatment adherence and engagement in our clinical programs,” she said.
Triple-S Advantage received a 4-star rating in its HMO contract and 4.5 stars in its Part D (Pharmacy) offering. The new ratings reflect a half-star reduction from last year’s ratings of 4.5 stars (HMO) and 5 stars (Part D), respectively, and will apply in payment year 2021.
“As standards for Medicare Advantage become more rigorous, maintaining a 4-star rating or higher becomes an even more vital objective to achieve,” said Hernández-Urquiza. “While the bar in star rating continues to be raised, these more stringent standards ultimately translate into better health services for our members.”
The CMS Star Rating System reflects the quality of care that the member receives, as well as their satisfaction with their plan, and considers measures such as: preventive tests, the management of chronic conditions such as diabetes and hypertension, the prevention of falls and hospital re-admissions and compliance with medication therapies, among others.
Each year, CMS collects this data and, based on it, issues a rating of one to five stars.