Based on the 5-Star Quality Rating System, Centers for Medicare and Medicaid Services (CMS) rate carriers on the performance of MA/MAPD plans. The scores range from (1) Poor to (5) Excellent.
WellCare manages these measures within five chapters.
- Admin/Ops (Administrative Operations)
- Measures how well WellCare is providing hassle-free care and services to their members and providers.
- CAHPS (Consumer Assessment of Healthcare Providers and Systems)
- Measures if members are happy with their experience.
- HEDIS (Healthcare Effectiveness Data and Information Set)
- Measures if WellCare is effectively getting members to care.
- HOS (Health Outcomes Survey)
- Measures if members think they are feeling better.
- Pharmacy
- Measures if members are getting and taking the medications as prescribed.
How did WellCare Perform?
They are pleased to share that their resource investments and one-team focused efforts are moving them in the right direction. Their PY 2019 Star rating improved to 3.57 from 3.43 last year overall. Thsi is their best performance to date, with improvement above the industry improvement average two years in a row. Importantly, this success provides access to enhanced quality bonuses that they will reinvest in additional benefits and programs for their members.
They want to thank you, their partners, for helping continue to improve their star ratings by providing quality support to their members.
Please download the 2019 star raing insert applicable to your market for use during the presentation of star scores to beneficiaries.
- Alabama H6975
- Arizona H5430
- Arizona H6439
- Arkansas H0270
- California H5087
- Connecticut H0712
- Florida H1032
- Florida H5199
- Georgia H0111
- Georgia H1112
- Hawaii H2491
- Illinois H1416
- Kentucky H9730
- Louisiana H2491
- Maine H9364
- Mississippi H1416
- New Jersey H0913
- New York H0088
- New York H2775
- New York H2816
- New York H4868
- North Carolina H0712
- South Carolina H4847
- South Carolina H7326
- Tennessee H1416
- Texas H0174
- Texas H4506
- Texas H5656
- Prescription Drug Plans
In addition, download WellCare's 2019 Star Score FAQ and 2019 Marketing Guidelines for details on presenting star scores to beneficiaries during the marketing process.