MetroPlus Health Plan Grabs Top Spot in New York State Health Quality Scores

New York State Department of Health awarded MetroPlus Health Plan the highest “quality measures” score among Medicaid managed care plans statewide, the Health Plan announced today. The State’s overall 2016 Quality Incentive results weigh the quality measures score especially heavily—representing two-thirds of its maximum possible score—pointing to their importance.

“Our quality measures score reflects the high quality of care we provide to our Medicaid recipients every day,” said Dr. Arnold Saperstein, President and CEO of MetroPlus Health Plan. “We are here to serve our members. The quality scores tell us that our members feel we are getting a lot of things right. All of us at MetroPlus, across every department, are extremely proud to have participated in the important work it took to achieve these results.”

In addition to its obvious importance for beneficiaries and those who are considering enrolling, the results are also important to the health plan since stronger results bestow incentive premium awards on the health plan. “We focus on quality for the good of our members, but the added financial benefit is welcome,” said Dr. Saperstein.

The areas where MetroPlus scored particularly highly include timeliness of prenatal care, administration of flu shots, smoking cessation, asthma medication management, and two key indicators of diabetes management. MetroPlus also received high scores for postpartum care and well child visits.

These results reflect the investment MetroPlus makes in keeping its members healthy. MetroPlus staff work closely with designated members throughout the year to remind them of appointments and to stress the importance of maintaining their medication regimens to improve their health.

Contributing to the impressive showing were a number of initiatives and improvements the Plan made recently with quality and member satisfaction in mind, including expanding the scope of its quality outreach and member engagement programs, improving provider data sharing, and collaborating more effectively with its vendors and business partners.

MetroPlus recently began a new member reward program designed to incentivize members to stay healthy. This program, provided under a contract with Finity, allows members to earn points for achieving health outcomes such as obtaining preventive care and completing needed health screenings. Members have already begun earning points and redeeming those points for prizes, such as art sets and basketballs.

The Plan, a wholly owned subsidiary of NYC Health + Hospitals, also attributes its success to the high quality of its provider network, including NYC Health + Hospitals and community providers, as well as a myriad of community partnerships.

With more than 30 years’ experience in managed care and over 500,000 members on board, MetroPlus will continue to reach out to New Yorkers in need of health insurance. The Plan can now add “highest scoring” to its core message of free or low-cost quality health care.


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