The law requires health insurers to use the bonus money to pay for extra benefits for its members, which, in turn, could help Premier compete against other local Medicare Advantage providers, including downtown Dayton-based CareSource, which will open for enrollment in its Medicare Advantage plan in Ohio for the first time this year.
In 2015 and 2016, only a small percentage of plans that achieved at least four stars overall had been in business for less than five years, according to Premier officials, who said their plan is in its third year of operation and in its first year of eligibility for a CMS star rating.
“As Medicare beneficiaries are choosing their coverage for next year, we’re thrilled our plan has been recognized for its ability to provide access to quality care, superior customer service and a coordinated approach,” said Dr. Jerry Clark, chief medical officer of Premier Health Plan. “This recognition by CMS demonstrates how a health insurance plan can stand out when it’s led by doctors and nurses who are local and whom you know and trust. It is validation of our unique population health model of care for the communities we serve.”
The components that make up Premier Health Plan’s overall rating include:
• five-star ratings for care coordination and health care quality;
• four-star ratings for customer service, providing appointments and care quickly, providing prescriptions quickly, and ensuring that needed care is provided.
“This milestone is a testament to our commitment to improving the health of the communities we serve, and to the hard work of our broad network of physicians, hospitals and other health care providers,” said Tom Duncan, chief executive officer, Premier Health Plan.
Enrollment in traditional Medicare and Medicare Advantage plans runs from Saturday through Dec. 7.
About the Author