MENASHA, Wis.--(BUSINESS WIRE)--Network Health, the Wisconsin-based health plan, earned a 4.5 overall Star rating for its Medicare Advantage PPO plans from the Centers for Medicare and Medicaid Services (CMS), outperforming the national average of 4 Stars. In addition, the National Committee for Quality Assurance (NCQA) awarded Network Health a 4.5 out of 5.0 rating for both Medicare and Commercial lines of business for 2019-2020. Network Health is one of only four health plans in Wisconsin receiving this score for Medicare and commercial plans, and no other plans in Wisconsin are rated higher.
The Medicare Advantage Five-Star Quality Rating System was implemented to drive improvements in quality of care and to help consumers make plan comparisons. CMS evaluates plans annually and base the Five-Star ratings results on clinical data, customer survey responses and plan performance scores spanning the previous two years. This information is timely as consumers start evaluating available health plans during open enrollment for 2020 insurance coverage. The Medicare annual enrollment period runs October 15, 2019 through December 7, 2019.
“These ratings recognize the satisfaction of our Network Health members and the excellent care they receive from our providers,” said Kimberly Swanson, MPA, vice president, quality and clinical integration of Network Health. “Our primary goal is to take care of our members by providing high-quality health care. Network Health has the hometown advantage, we know how to serve our members, because we live and work in the same communities.”
NCQA ratings are based on clinical quality, member satisfaction and NCQA Accreditation survey results. Ratings emphasize care outcomes and how members rate their care. Ratings are also given on a scale of zero to five, with five being the highest rating. Network Health is ranked in the top 38 commercial plans and top 25 Medicare plans of the more than 1,000 plans that are NCQA rated.
The health care industry is striving to make improvements in the delivery of high-quality care and the overall member and patient experience. Consequently, thresholds for many measures change annually making it more challenging for Health Insurance Plans to achieve high Star ratings. Several key factors that contributed to Network Health’s achievement of a 4.5 Star rating, including five Star performances in all diabetic, dedication, adherence and health plan complaint measures.
Network Health has always partnered with local providers, including provider owners Ascension and Froedtert, to offer high-quality coverage. With this 4.5 Star rating, Network Health is currently the largest provider-owned Medicare Advantage plan in Wisconsin outranking the national average.
About Network Health
Founded in 1982, Network Health offers customized commercial and Medicare health insurance services to employers, individuals and families in more than 23 counties throughout Wisconsin. Through its strong reputation for quality health care coverage and superior customer service, Network Health has grown to serve more than 120,000 members. Learn more at networkhealth.com. Visit our blog at copilotwi.com.