MetroPlus Ranked New York City’s Highest-Rated Health Plan

NEW YORK--()--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 2018 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, MetroPlus Health Plan earned an overall rating of 5 stars, the highest possible score. More stars mean better healthcare. “This outstanding result is another indication of the superior healthcare and coverage that MetroPlus members receive and is reflective of the excellent MetroPlus provider network that puts quality healthcare - and our members - first,” said Dr. Arnold Saperstein, President and CEO of MetroPlus.

The health plan’s 2018 5-star Overall Rating included 5 stars in the clinical areas of Cardiovascular Care, Diabetes Care, Child and Adolescent Care , Women’s Preventive Care, and Adult Care.

The 2018 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 2018 Consumer’s Guide can be found at:

MetroPlus 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 MetroPlus 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. MetroPlus 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 MetroPlus 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 has to go to the entire team at MetroPlus,” Dr. Saperstein 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,” he 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 of Brooklyn, the Bronx, Manhattan, Queens and Staten Island. A wholly-owned subsidiary of NYC Health + Hospitals, the nation’s largest public health system, MetroPlus is the plan of choice for over half a million New Yorkers. In addition to Medicaid Managed Care, MetroPlus offers Child Health Plus; several Medicare Plans; a Special Needs Plan (SNP) for people with HIV and their families; a Long-Term Managed Care Plan; MetroPlus Gold, a plan exclusively for New York City employees; FIDA and HARP plans, and almost four dozen NY State of Health Marketplace products. The company’s robust network of primary care doctors and specialists includes many independent community providers. Culturally sensitive, and fluent in more than 40 languages, MetroPlus staff is as diverse as the great city it serves. Visit us at and join the conversation at and twitter @metroplushealth.


Kathryn Knox Soman

Release Summary

MetroPlus Health Plan announced today that it has been ranked New York City’s highest-rated health plan.


Kathryn Knox Soman