BlueCross Medicare Advantage PPO Plan Earns 4-STAR Quality Rating

  • Thursday, October 8, 2015
BlueCross BlueShield of Tennessee’s Medicare Advantage PPO product secured a 4-STAR quality rating from the Centers for Medicare and Medicaid Services. The assessment validates the effectiveness of the company’s programs designed to boost member health outcomes and satisfaction.

CMS issues the quality ratings based on customer satisfaction surveys covering 50 measures, including whether members get the recommended care and screenings, how well their health conditions are managed and how satisfied they are with their health plan experience.

“This 4-STAR rating substantiates all the effort BlueCross has put in to improve the member experience and give our members peace of mind,” said Todd Ray, vice president and general manager of senior products.
“Our goal is to be more than an insurance company. We are a partner in our members’ health.”

The BlueCross Medicare Advantage team launched a number of initiatives in an attempt to boost their previous 3.5 STAR rating. Some of those initiatives include My HealthPath®, a program that encourages members to get the care they need to stay healthy. The program uses education efforts and customized service, such as scheduling checkups or home based assessments.

The team also put significant effort into provider engagement. They deployed pay-for-performance programs that are supported by a new provider quality portal. This tool makes it easier for physicians to identify and close the preventive gaps-in-care for their patients.

Dr. J.B. Sobel, vice president and chief medical officer for senior products, said the new ranking reflects an enterprise-wide effort that will continue improving health for members.

“Every day we embark upon the mission to improve our members’ health,” he said. “We will continue working for their peace of mind to ensure they receive the best health care available at the best value.”
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