Triple-S Advantage increases rating as 4.5-star quality plan
Triple-S Management announced that for 2022 its Triple-S Advantage coordinated care contract (HMO H5774) increased its rating to 4.5 stars out of 5 in the Centers for Medicare & Medicaid Services (CMS) quality rating system, the regulatory agency for Medicare Advantage plans.
In addition, its preferred provider contract (PPO H4005) increased its quality rating to 4 stars. Also, the pharmacy services (Part D) of both contracts received a 5-star rating.
The company attributed the to its strategies and close collaboration with its physicians and business partners to offer quality services to the more than 136,000 Medicare Advantage members they serve.
“This recognition reflects our commitment to providing excellent service to our members and other stakeholders, and quality clinical programs that facilitate a holistic care,” said Triple-S CEO Roberto García.
“Enabling healthy lives is our guiding principle in all clinical and service initiatives at Triple-S Advantage. We constantly seek innovative benefits and services that support better health outcomes, including attention to the social factors impacting health,” he said.
“We also seek to improve members’ experience with their plan and the providers that serve them. That approach has enabled us to maintain our position as a plan characterized by excellence,” García added.
The upgraded ratings are an additional validation of the company’s efforts throughout the pandemic. Triple-S Advantage redoubled its efforts to provide and facilitate access to health services and address social factors during one of the country’s most severe public health crises.
“Not only did we meet CMS’s strict requirements, but we expanded telemedicine services, facilitated food delivery for close to 44,000 of our most vulnerable members and covered the cost of prepared food delivery for others. We also made it easier for our members to manage and receive their prescriptions and OTCs with the launch of the Triple-S en casa app,” added García.
The CMS Star Rating System reflects the quality of care a member receives, as well as the level of satisfaction with their plan. It considers measures such as preventive screenings, management of chronic conditions, such as diabetes and hypertension, prevention of falls, hospital readmissions and the level of member adherence to drug therapies, among others. Each year, CMS compiles this data and based on it issues a rating from one to five stars, with 1 star being poor performance and 5 stars representing exceptional service. Star Ratings are calculated each year and may change from one year to the next.