The Centers for Medicare and Medicaid Services (CMS) has recognized Independent Health as a 5-Star Rated Medicare Advantage Plan for 2022. After several years of consistently achieving a 4.5-Star Rating, this marks the first time the Williamsville-based company has earned the highest score a plan can receive from CMS. In fact, Independent Health is one of only seven health plans in the nation with multiple Medicare Advantage contracts to be awarded 5 stars for its entire 2022 Medicare Advantage product portfolio.
The Star Ratings are designed to help people assess the quality, value and performance of every Medicare Advantage plan throughout the nation. As a 5-Star Rated plan, Independent Health will now have the ability to enroll Medicare beneficiaries in its Medicare Advantage plans throughout the entire 2022 calendar year – not just during the annual open enrollment period.
“Independent Health is very proud to be among a select group of health plans in the nation – and the only one in Western New York – to receive 5 stars from CMS for every Medicare Advantage plan that it’s offering in 2022,” said Michael W. Cropp, M.D., President & CEO, Independent Health. “Our 5-Star Rating is a testament to our collaborative efforts with health care providers to ensure our members receive the care they need as well as our long-standing commitment of providing outstanding customer service. When it comes to choosing a Medicare Advantage plan, Western New Yorkers can be assured they will receive high-quality coverage and value with Independent Health.”
In addition, Independent Health’s subsidiary, Pharmacy Benefit Dimensions (PBD), has once again received a 5-Star Rating for its Medicare Employer Group Waiver Plan (EGWP) Prescription Drug Plan (PDP). The plan previously earned 5-star status for 2019. PBD partners with employers and union groups to offer its EGWP PDP to Medicare-eligible retirees and covered Medicare-eligible dependents beyond the standard benefits typically offered by other Medicare prescription drug plans.
How Star Ratings Are Measured
By using a 5-Star Quality Rating System, with 5 Stars being the highest rating, CMS measures Medicare beneficiaries’ experience with their health plans and the health care system on an annual basis. Health
and pharmacy services are rated together through information gathered from clinicians, member surveys and other trusted sources. Each plan is then given an overall summary rating based on how it performs across several categories, including:
- Staying healthy: Rates how often members got various screening tests, vaccines and other checkups to help them stay healthy.
- Managing chronic (long-term) conditions: Rates how often members with different conditions got certain tests and treatments to help them manage their condition.
- Member experience with the plan: Rates member satisfaction with the plan based on how easy it is to get needed care, appointments, information and help from the plan (customer service).
- Member complaints and changes in the plan’s performance: Measures how many complaints Medicare received about the plan, the number of members who chose to leave the plan and how the plan’s quality improved or declined from the previous year.
- Customer service: Rates the timeliness and fairness of the plan’s appeals decisions.
- Drug safety and accuracy of drug pricing: Rates how well the plan prices prescriptions and provides updated information on the Medicare website. Also rates information on how often members with certain medical conditions get prescription drugs that are considered safer and clinically recommended for their condition.
The Medicare Star Ratings program was created in 2008; however, it wasn’t until three years later that CMS began to assign overall ratings. Prior to this year’s ratings, Independent Health had earned 4.5 stars for its Medicare HMO plans for 11 consecutive years and its Medicare PPO plans for six straight years.
With this year’s Medicare open enrollment period scheduled to begin this Friday, October 15, Western New Yorkers are encouraged to review and consider each plan’s Star Ratings before selecting their Medicare Advantage coverage for 2022.
“The Star Ratings serve as a helpful and unbiased way for Medicare beneficiaries to objectively compare their medical and prescription drug options for 2022 and choose the plan that is right for them,” said Cathy Aquino, director of government sales, Independent Health. “To learn more about Independent Health’s 2022 Medicare Advantage plans and benefits, you can meet in person with a RedShirt® at one of our Medicare Information Centers or connect with us by phone or video chat.”