Blue Cross and BCN receive high Medicare Star Ratings from CMS

The Centers for Medicare & Medicaid Services recently announced its 2022 Medicare Star Ratings — and Blue Cross Blue Shield of Michigan performed very well.

• Our BCN Advantage℠ HMO plan now has a 5-Star rating — the highest rating possible and the first 5-Star rating Blue Cross Blue Shield of Michigan has ever achieved.
• Our Medicare Plus Blue℠ PPO plan now has a 4.5-Star rating, an increase of one star over last year.

These were the only two Medicare Advantage plans in Michigan that both improved by one full star over the previous year.

CMS publishes Star Ratings each year to measure the quality of health services received by beneficiaries enrolled in Medicare Advantage plans. They’re designed to evaluate how well plans that contract with Medicare perform, and to help consumers select a Medicare Advantage plan that works best for them.

“Ensuring our senior members receive the quality health care and services they need is essential to delivering the exceptional Medicare Advantage plans members expect from Blue Cross Blue Shield of Michigan,” said Daniel J. Loepp, Blue Cross president and CEO. “These high ratings from CMS are a testament to the work we put in every day to maintain the highest quality networks and access to care, in addition to taking care of our members’ complete health needs.”

Medicare considers five categories when assigning a Star Rating:

• How the plan emphasizes staying healthy, including such benefits as screenings, tests and vaccines
• How the plan manages chronic conditions
• How responsive the plan is, as well as the quality of care that people with the plan receive
• Member complaint reports, which include problems in getting services and decisions on appeals
• How many members leave the plan each year

Blue Cross Blue Shield of Michigan’s high ratings for 2022 reflect improvements made in several key areas, including HEDIS^® measures* and CAHPS^® surveys.** The Consumer Assessment of Healthcare Providers and Systems surveys, developed by the Agency for Healthcare Research and Quality, evaluate a member’s experience with their plan, quality of care received and access to care.

The role of health care providers
In a letter to physician organization administrators and medical directors, Dr. James Grant, senior vice president and chief medical officer for Blue Cross, acknowledged the important role health care providers played in achieving the ratings. “We couldn’t have achieved this strong performance without your partnership and the efforts of the entire care team — the physicians, the nurses, the physician assistants, the medical assistants and all those who touch our patients either face to face or behind the scenes,” he wrote. “Strong HEDIS results are directly associated with quality care. Members also indicated a favorable perception of their health care experience through this year’s CAHPS scores.”

Going forward, Blue Cross and BCN will continue to work with health care providers to focus on quality, pursue operational excellence and provide a best-in-class experience to our members.

*HEDIS^®, which stands for Healthcare Effectiveness and Information Set, is a registered trademark of the National Committee for Quality Assurance.

**CAHPS^®, which stands for Consumer Assessment of Healthcare Providers and Systems, is a registered trademark of the Agency for Healthcare Quality and Research.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.