CMS results for 2019 show high quality, positive member experience
CHATTANOOGA, Tenn. — BlueCross BlueShield of Tennessee’s Medicare Advantage PPO product has earned a fourth consecutive 4- out of 5-Star quality rating from the Centers for Medicare and Medicaid Services (CMS).
The CMS ratings, released annually, are established through a review of plan operations, customer surveys, and member outcomes for more than 50 quality measures. These measures look at how well members’ chronic health conditions are controlled and whether members get their recommended care and screenings, as well as their overall satisfaction with their health plan experience.
The BlueCross Medicare Advantage PPO ranked high in several areas for 2019, and earned a second consecutive 5-Star rating for customer service.
“This lets us know that our members are getting the information they need about how to use our plan and their benefits,” said Todd Ray, senior vice president of senior products for BlueCross. “We will continue our efforts to enhance our program’s effectiveness by partnering with providers and utilizing data to ensure our members get the health care they need, when they need it.”
The BlueCross Medicare Advantage team uses a variety of methods and approaches to continuously improve health outcomes for members. Some of those efforts include:
- Finding ways to remove financial barriers for members to keep them compliant with their health care provider’s treatment plans
- Enhancing value-based reimbursement programs with data sharing arrangements that increase the amount of clinical information available to providers
- Adding a focused incentive program for members who need CMS-recommended tests and treatments
- Facilitating checkups or home-based assessments for members with limited mobility
Dr. J.B. Sobel, vice president and chief medical officer for senior products at BlueCross, said the program’s continued success stems from a commitment to partnership with providers and regular outreach to members.
“We have focused our product and culture around improving the member’s health outcomes and experience, and building lasting relationships with the clinicians who provide care to those we serve,” he said. “Our members value the benefits and experience that we provide, and we are grateful for the opportunity to serve them in our Medicare Advantage program.”
BlueCross BlueShield of Tennessee’s mission is to provide peace of mind through better health. Founded in 1945, the Chattanooga-based company is focused on serving more than 3.4 million members in Tennessee and across the country. BlueCross BlueShield of Tennessee Inc. is an independent licensee of the BlueCross BlueShield Association. For more information, visit the company’s website at bcbst.com.