BlueCross Medicare Advantage Plans Earn 4.5-Star, 4-Star Quality Ratings From CMS | Financial Buzz

BlueCross Medicare Advantage Plans Earn 4.5-Star, 4-Star Quality Ratings From CMS

Two BlueCross BlueShield of Tennessee plans have earned high marks for quality care and member service from the Centers for Medicare & Medicaid Services (CMS) for 2022. The company’s Medicare Advantage PPO plan earned a 4.5-Star quality rating, and the Dual Special Needs program (which serves members who are eligible for both Medicare and Medicaid) earned a 4-Star rating.

CMS ratings are issued after a review of plan operations, including members’ reported experiences and health outcomes. Medicare Advantage plans, whose benefits include prescription drug coverage, are analyzed across more than 40 different quality and performance metrics. This year’s ranking took into account:

  • how successfully BlueCross members’ chronic health conditions were managed,
  • the timeliness of members’ screenings and health treatments, and
  • members’ satisfaction with their health plan as a whole.

This year, BlueCross’ Medicare Advantage PPO earned the highest possible rating on almost every measure, further demonstrating how effectively BlueCross supports its members in following their providers’ recommendations for care. Leaders credit the achievement to an effective use of new technology and, above all, employees’ commitment to excellence in serving members.

“Our greatest success has come from looking out for our members as well as the providers who deliver their care,” said Annamarie Rakes, director of Quality Improvement for Senior Products at BlueCross. “We’ve committed to finding the best ways to help patients achieve and maintain their health goals. Our teams make the difference — they take responsibility at every level to put our members first, and it shows.”

As the COVID-19 national public health emergency continues, the BlueCross senior care teams have partnered with providers and members in a variety of creative ways to help maintain and enhance access to quality health care. These efforts have included:

  • outreach drives with doctors’ offices to encourage use of at-home colorectal screening and community-based breast screening opportunities,
  • collaborating with providers and pharmacists to ensure members are sticking to their recommended care plan for prescription medications, and
  • working closely with provider offices to support telehealth and other efforts that ensure the right care is being provided at the right time.

Dr. J.B. Sobel, vice president and chief medical officer for Senior Products at BlueCross BlueShield of Tennessee, says the organization remains focused on taking every opportunity to provide the best possible support to members.

“As the pandemic continues, we have learned more about the best ways to support and engage our members wherever they are in their health journey, while collaborating even more effectively with our provider partners throughout the state,” he said. “We are proud of our performance and the positive impact of our network providers, who are overburdened during the COVID-19 national public health emergency but are still working diligently to deliver comprehensive, high-quality health care.”

About BlueCross®

BlueCross BlueShield of Tennessee is a taxpaying, not-for-profit health plan serving more than 3.4 million members in Tennessee and around the country. The Chattanooga-based company was founded in 1945 and has brought peace of mind to its members and local communities for more than 75 years. BlueCross BlueShield of Tennessee Inc. is an independent licensee of the BlueCross BlueShield Association. For more information, visit the company’s news center at bcbstnews.com.

Contacts

Alison Sexter

(423) 535-3134

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