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Priority Health leads in quality as the only Michigan-based Medicare plan to receive the highest possible rating of 5 stars from federal health agency

Priority Health leads in quality as the only Michigan-based Medicare plan to receive the highest possible rating of 5 stars from federal health agency

Priority Health has once again been nationally recognized for the quality of its Medicare Advantage plans through the 2023 Medicare Star Ratings released by the Centers for Medicare and Medicaid Services (CMS), a part of the U.S. Department of Health and Human Services.

Priority Health’s HMO Medicare Advantage product received 5 stars – the highest possible rating from CMS; only 57 out of 507 plans nationwide earned 5 stars.

“This rating shows our commitment to ensuring our members get the care they need at an affordable cost,” said Joyce Chan Russell, senior vice president of government markets at Priority Health. “Priority Health is a leader in quality and will continue offering better benefits and lower premiums for Medicare members.”

CMS also awarded Priority Health’s other Medicare Advantage plans an additional half star above the previous year – the PPO plan received 4.5 stars and the Dual-eligible Special Needs Plan received 4 stars.

The Medicare 5-Star Rating program is a national rating system used by CMS to shine a light on health plan quality and performance. The program evaluates how well a plan performs across many different quality measures, which are related to health outcomes, plan operations and member satisfaction.

Star Ratings are available each fall and given on a contract-by-contract basis. CMS awards quality bonus payments (QBPs) to highly rated Medicare plans. A health plan’s overall Star Rating is based on a weighted average of the plan’s performance on measures across several categories, including health management, chronic condition management and member experience, among others.

NCQA Ratings

In a separate rating system, Priority Health was also recently recognized as a top performer by the National Committee for Quality Assurance (NCQA). In the NCQA Medicare Health Plan Ratings for 2022, Priority Health’s Medicare HMO/POS and PPO plans each received 4.5 stars (out of 5), making them the top-rated Medicare plans in Michigan and among the highest-rated plans in the nation.

NCQA also recognized Priority Health’s Medicaid and commercial plans. Priority Health’s Medicaid product rated second highest in the state, with 4 stars given to the HMO plan. The commercial HMO/POS and PPO plans also each received a 4-star rating, which is the highest rating achieved for all commercial plans offered in Michigan.

“Being again recognized as a national top performer is a direct reflection of our concerted effort to ensure our members continue to receive high-quality care and service,” said Praveen Thadani, president of Priority Health. “These ratings are great encouragement to continue our mission of transforming health care through improved patient outcomes and cost reduction, and I am extremely proud of the talented Priority Health team for working to accomplish just that.”

NCQA and CMS ratings were released ahead of annual and open enrollment. The open enrollment period for individual and family health plans is November 1-January 15. The annual enrollment period for Medicare is October 15-December 7.

About Priority Health

With over 30 years in business, Priority Health is the second largest health plan in Michigan, offering an extensive portfolio of health benefits options for employer groups and individuals, including Medicare and Medicaid plans. Serving more than one million members each year and offering a broad network of primary care physicians in Michigan, Priority Health continues to be recognized as a leader for quality, customer service, transparency and product innovation. Learn more about affordable, quality health coverage options from Priority Health.

Kelsey Pardue | (616) 464-4818 | Kelsey.pardue@priorityhealth.com

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