MetroPlus Health ranked New York’s highest-rated health plan

Family with stethoscope and a red heart. Concepts of a physical examination and health insurance.
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MetroPlus Health Plan announced today that it has been ranked New York City’s highest-rated health plan, according to the New York State Department of Health’s 2020 Consumer’s Guide to Medicaid and Child Health Plus Managed Care Plans in New York City, the annual rating of managed care plans on quality of care delivered and members’ satisfaction with the care and services they receive.

In New York City, MetroPlusHealth earned 5 stars in a number of categories and an overall rating of 5 stars, the highest possible score. More stars mean better healthcare.  

“This outstanding result is another proof of the superior healthcare and coverage that over 600,000 MetroPlusHealth members receive and is reflective of the excellent MetroPlusHealth provider network that puts quality healthcare – and our members – first,” said Talya Schwartz, MD, President and CEO of MetroPlusHealth. 

The health plan’s 2020 5-star Overall Rating included 5 stars in the clinical areas of Cardiovascular Care, Diabetes Care, Child and Adolescent Care, and Adult Care. 

The 2020 Consumer’s Guide rates plans on 10 distinct measures across three categories – Preventive and Well-Care for Adults and Children, Quality of Care Provided to members with Illnesses, and Patient Satisfaction with Access and Services – ultimately resulting in an Overall Rating of 0 to 5 stars. Ratings are based on a comparison of plan rates to statewide averages. Quality ratings are from information submitted by health plans. Patient satisfaction ratings are from a member survey conducted for the Department of Health. Results for measures involving children and adolescents are based on members of both Medicaid and Child Health Plus. The complete 2020 Consumer’s Guide can be found here.

MetroPlusHealth attributes its 5-star rating, a feat shared by only one other plan in New York City, to a number of factors, including:

Hyperfocusing on Quality Management 

The MetroPlusHealth Quality Management (QM) Department has been at the forefront of the health plan’s continuously improving quality measure scores. Providing convenient access to care through community events hosted by the QM team, for example, helped the Plan close gaps in care for measures such as dental and diabetic eye screenings, as well as critical completion of flu shots. MetroPlusHealth also increased member and provider education and participation in closing gaps in care by modernizing outreach through texting programs and ongoing social media postings. Yet the Plan strategically retained some traditional methods that work well with their population, such as mailings and personalized telephonic outreach. 

Rewarding Members for Completing Healthy Activities 

Another factor in increased member satisfaction and quality of care was the Plan’s Member Rewards Program, launched in 2017. The Member Rewards Program enables members to earn points, redeemable for premium items, by completing essential healthcare services such as well-visits, colonoscopies, medication adherence, and more, and healthy activities such as the STEP-UP CHALLENGE, where members track and work to increase their physical activity.  Significant improvement in member completion of required health screenings made a substantial impact on the HEDIS/QARR measure rates which directly affects the overall rating.  

Improving Communications Between Departments

Enhanced communications between departments was also key to the Plan’s highest-rated plan ranking. This includes sharing responsibilities for improvement interventions between Quality Management, Integrated Care Management, Partnership in Care (for HIV-positive and transgender members), Behavioral Health, and Pharmacy to name some of the essential Medical Management departments.  “Credit must go to the entire team at MetroPlusHealth,” Dr. Schwartz said. “Without the dedication and hard work done by each and every one of our staff, as well as our partners at NYC Health + Hospitals, we would not have topped the rankings this way,” she added. “Our team is the reason we earned our stars.”

About MetroPlus Health Plan

Since 1985, MetroPlus Health Plan has built a reputation for providing access to affordable, quality health care to residents across New York City. A wholly-owned subsidiary of NYC Health + Hospitals, the nation’s largest public health system, MetroPlusHealth is the plan of choice for over 600,000 New Yorkers and has a five-star rating based on the State’s 2020 Consumer’s Guide to Medicaid and Child Health Plus Managed Care Plans in New York City. The plan’s robust network of primary care doctors and specialists includes many independent community providers. Culturally sensitive, and fluent in more than 40 languages, MetroPlusHealth staff is as diverse as the great city it serves. For more information about MetroPlusHealth plans, benefits, and services, visit www.metroplus.org and join the conversation at facebook.com/MetroPlusHealth/and twitter.com/ @metroplushealth.