Tufts Health Plan Medicare Preferred HMO and Senior Care Options Plans Earn 5 Stars – the Highest Rating from Centers for Medicare and Medicaid Services

Recognized for its quality and performance, Tufts Health Plan has earned 5 stars out of a possible 5 for its Tufts Medicare Preferred HMO and Senior Care Options plans from the Centers for Medicare and Medicaid Services (CMS) as part of its annual Star ratings for 2016. Tufts Medicare Preferred HMO is the largest Medicare Advantage plan in Massachusetts with nearly 105,000 members.

This achievement comes after several consecutive years of earning 4.5 stars in the annual CMS ratings. CMS rated 369 Medicare Advantage plans this year. The rating puts Tufts Medicare Preferred HMO and Senior Care Options plans among the top 3.25% of plans nationally.

“A top priority at Tufts Health Plan is working closely with the physicians in our network to consistently improve quality, member satisfaction, and health outcomes for our members, which is reflected in this year’s achievement of earning a five-star rating for our plans,” said Patty Blake, president, Senior Products. “Bringing excellent care and service to older adults, many of whom have complex needs, is made possible through the hard work of our team at Tufts Health Plan and the collaborative relationships we build with our physician groups.”

CMS calculates Star ratings from 1 to 5 (with 5 being the best) based on quality and performance for Medicare health and drug plans to help beneficiaries, their families and caregivers compare plans. Ratings are given for quality measures across five categories for plans covering health services: staying healthy, managing chronic conditions, member satisfaction, customer service and pharmacy services.

Tufts Medicare Preferred HMO and Senior Care Options plans received 5 stars in 30 out of 44 measures including:

• Improving or Maintaining Mental Health
• Controlling Blood Pressure
• Getting Appointments and Care Quickly
• Customer Service
• Care Coordination
• Rating of Health Care Quality
• Health Plan Quality Improvement
• Getting Needed Prescription Drugs

This top rating from CMS comes on the heels of a recent announcement that Tufts Health Plan’s private HMO/PPO Commercial plans received a rating of 5 – the highest rating possible – by the National Committee on Quality Assurance.* Only 11 plans in the entire country – out of more than 400 that were rated – achieved this high rating. Tufts Health Plan’s Medicaid plans also rated very high, achieving a 4.5 out of a possible 5.**

About Tufts Health Plan

Tufts Health Plan is nationally recognized for our commitment to providing innovative, high-quality health care coverage. Staying true to our mission of improving the health and wellness of the diverse communities we serve, we touch the lives of more than one million members in Massachusetts and Rhode Island through employer-sponsored plans; Medicare; and Medicaid/subsidized plans, offering health insurance coverage across the life span regardless of age or circumstance.

* The National Committee for Quality Assurance (NCQA) Private Health Insurance Plan Ratings 2015-2016.

** NCQA’s Medicaid Health Insurance Plan Ratings 2015-2016.

Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. Visit Medicare.gov for more information.

Tufts Health Plan Medicare Preferred is an HMO plan with a Medicare contract. Enrollment in Tufts Medicare Preferred HMO depends on contract renewal. The Senior Care Options plan is available to those 65 and older who have MassHealth Standard (Medicaid).

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