One of the US’ leading non-profit health systems, Group Health Cooperative, announced on 12 October that its Clear Care (HMO) Medicare Advantage health plan received an overall rating of five stars for Parts C and D, the highest rating from The Centers for Medicare & Medicaid Services (CMS) for 2013. Group Health prides itself with putting its partner’s needs first, helping them to maximise their health.
Group Health Cooperative is a members-owned organisation that devotes all income to the provision of health care services. The purpose of Group Health is not making profit, but rather establishing the best health care facilities and programmes.
"At this time of change in American health care, we owe it to our citizens to give the best care and service at the most affordable price, and quality is a critical part of that equation," said Michael Soman, MD, President and Chief Medical Executive for Group Health Physicians. He added: "At Group Health, our work to improve quality is never done. Each improvement we make starts with our patients' needs, and depends on the commitment of every person who works here to make patient experience better, every day."
Recognised for its consumer-governed cooperative origins and innovative solutions for improving care, Group Health Cooperative is also supporting the Health Care Reform put forward by President Obama.
Group Health has been implementing some of the reforms proposed by the Obama Administration for a long time. Practices such as electronic medical records, the medical home, patient-centred care, comparative effectiveness, and shared decision-making are already at work, creating the exceptional care experience our members value.
The co-op is also trying to keep its members informed about the way in which the Health Care Reform will impact on them by providing information and advise. Furthermore, members can attend a free seminar in which they will get the chance to find out more about Group Health’s programmes and healthy ageing.
Through the Medicare Star Quality Rating System, CMS assigns scores of one to five stars to Medicare Advantage plans based on more than 50 care and service quality measures across five categories.
These include: staying healthy, managing chronic conditions, member satisfaction, customer service, and pharmacy services. Five stars represent plans with the greatest ability to consistently deliver quality care and service to Medicare beneficiaries.
"CMS rewards health plans for a high level of consistent performance, and Group Health Cooperative's deep commitment to continuous improvement has paid off as we achieved a score that recognises year over year high performance across all measures," said Scott Armstrong, President and CEO for Group Health Cooperative.
He continued: "Group Health is committed to providing the highest quality care and service to our members. We are honoured that our plan received such an excellent rating once again this year."
Eric B. Larson, MD, MPH and Executive Director of Group Health Research institute, said: “Medicare ‘five stars’ creates a way to tell who’s the best at something. It is not just – are you good enough to be in the market – but are you at the top of the market? And a ‘five stars’ [rating] is very hard to get, but it means a lot to everyday consumer. To get a ‘five stars’ puts you in the elite of the elite.”
Group Health Cooperative's Clear Care (HMO) Medicare Advantage plan was also ranked 9th in the nation among 403 health insurance plans by the National Committee for Quality Assurance (NCQA) Medicare Health Insurance Plan Rankings 2012–2013.
NCQA is an independent, not-for-profit organisation dedicated to assessing and reporting the quality of managed care plans to help consumers, employers and others make informed healthcare choices. For more information, and to see the rankings, visit www.ncqa.org.
Established in 1947 as a community coalition dedicated to making quality health care available and affordable, Group Health Cooperative, together with its subsidiaries Group Health Options, Inc. and KPS Health Plans, provides health coverage to over 626,000 residents of Washington State and North Idaho.
Today Group Health Cooperative it is one of the few health care organizations in the country governed by consumers. Its 11-member Board of Trustees — all health-plan members elected by other members — work closely with management and medical staff to ensure that the organization's policies and direction put the needs of patients first.
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