Annual review for 2023 highlights insurer’s dedication to optimizing member experiences and health outcomes
CHATTANOOGA, Tenn. — Each year, Medicare plans are evaluated based on a 5-star rating system, and BlueCross BlueShield of Tennessee (BlueCross)’s BlueAdvantage PPO plan has earned the highest possible rating from the Centers for Medicare & Medicaid Services (CMS) for 2023. The 5-Star quality rating reflects a commitment to superior member service.
This year’s achievement represents the second score increase in two years and makes BlueCross the only 5-star PPO plan headquartered in Tennessee. The company’s leaders credit this to employees’ unwavering commitment to provide excellent support for members in every interaction.
“Our teams are dedicated to collaborating with providers to ensure communication and outreach is as clear and supportive as possible, and to provide members with individualized options to achieve and maintain their health goals in a way that works best for them,” said Dr. Angeline Brunetto, vice president and chief medical officer for senior products. “Our people continually take responsibility to put our members first, and it shows.”
CMS determines ratings after a review of plan operations and member satisfaction, including analysis of:
• How members rate their health plan’s customer service and support in getting care overall;
• How the plan supports members in safely and appropriately using prescriptions, and
• How well the plan’s in-network doctors and providers help prevent and manage members’ chronic illnesses.
Medicare Advantage plans with prescription drug coverage are evaluated against more than 40 different measures related to performance and quality. Members’ reported experiences with their health plan and rates of members getting recommended preventive care and screenings make the biggest impact.
With COVID-19 still a public health concern during the measurement period for the 2023 ratings, BlueCross BlueShield of Tennessee teams have continued to emphasize flexibility and creative solutions for addressing member concerns related to seeking screenings and care, according to Ann Rakes, director of quality improvement for senior products.
“We know the consumer health experience is more important than ever in terms of engaging members to take an active role in their own care,” she said. “Members who feel they are treated well and understand why they’re being asked to get screenings, establish certain habits or follow medication regimens are more likely to have positive health outcomes.”