Why the Medicare Star Rating Is Important to You

For the second year in a row, Viva Medicare, has received 4 stars – the highest star rating in Alabama! The Centers for Medicare & Medicaid Services (CMS) rates the relative quality of Medicare Advantage plans, like Viva Medicare, as a way of helping beneficiaries assess the quality of Medicare Advantage plans that they’re considering joining. CMS rates Medicare Advantage plans on a one to five-star scale, with five stars representing the highest quality.

Medicare’s overall plan rating provides you with a single summary score that makes it easy for you to compare plans based on quality and performance. The easiest way to see where your plan ranks in Alabama is to visit www.medicare.gov and search for health plans in your zip code.

So, you may be asking, “What exactly is being measured?” Simply put, the overall star Rating combines scores for the types of services each plan offers:

For plans covering health care services, such as a Medicare Advantage plan, the overall score for quality of those services covers specific topics in 5 categories:

Promoting Good Health: The goal of any health care provider is to encourage you to stay healthy. A good Medicare Advantage plan will inform and remind you about screenings, tests, and vaccines such as colonoscopies, mammograms, diabetic screenings, and flu shots.

Managing chronic (long-term) conditions: This measurement includes how often members with different conditions get certain tests and treatments that help them manage their condition.

Member experience with the health plan: Member satisfaction is important. Every year, members are asked to rate their current Medicare Advantage plan. Viva Medicare received the highest member satisfaction rating of any plan in the state according to the 2016 Medicare & You Handbook for Alabama.

Member complaints, problems getting services, and improvement in the health plan’s performance: One of the distinguishing factors in determining a poor Medicare plan is patterns. Are members filing complaints against a plan? Is a plan losing membership? How has the performance of the plan improved over the years?

Customer service satisfaction: Great customer service goes a long way. This includes how well and quickly a plan responds to calls from members, makes decisions about member appeals for health coverage, and how it handles new enrollments in a timely manner.

At Viva Medicare, a high Star Rating allows us to offer better benefits, keep our copays low, and provide members with access to excellent doctors and facilities.

If you are a Viva Medicare member, you can help!

Complete your HRA. All new members will be asked to complete a telephonic Health Risk Assessment (HRA). This will take about 15 minutes of your time, and it will help us get to know you and your health needs.

Take your medications! It is important for you to take your medications as your doctor prescribed, especially if you have high blood pressure, diabetes, or high cholesterol. If you have questions about your medications, ask your doctor or ask us here at Viva Medicare. We’re here to help.

Get your preventive services. Make sure you get your flu shot, eye exam, and other preventive services like mammograms, colorectal screens, and cholesterol, blood pressure, and blood sugar checks.

Return your member satisfaction survey. Member satisfaction is the key to our success. We send out a member satisfaction survey every spring, and we want to know how we’re doing. If you get a member satisfaction survey, please fill it out.