Triple-S Management Corp., a leading managed-care company in Puerto Rico, announced today that the 2020 Care Coordination Medicare Advantage HMO contract of its subsidiary, Triple-S Advantage, remains among those Medicare Advantage (MA) plans with at least a 4-star rating for a fourth consecutive year.
As determined by the Centers for Medicare and Medicaid Services (CMS), the highest rating for an MA health maintenance organization (HMO) is 5 stars.
"Only 1 in 3 Medicare Advantage plans are 4 stars or higher in the U.S.," said Madeline Hernández-Urquiza, president of Triple-S Advantage. "This is the fourth straight year we have earned a 4-star rating or higher. While we are 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."
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 current 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," Hernández said. "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 readmissions and compliance with medication therapies, among others. Each year, CMS collects this data and issues ratings of one to five stars.