Rating of Plan is among top 25% of rated plans in U.S.
San Juan, Puerto Rico – Triple-S Advantage received a rating of 4.5* of 5 stars from the Centers of Medicare and Medicaid Services (MS) for its main Advantage healthcare contract, which has more than 90% of its Advantage members.
“We have closely collaborated with our providers and members to achieve this quality acknowledgement that reflects our joint effort to improve the health of our members,” said Thurman Justice, President of Triple-S Advantage.
Annually, CMS issues a Star rating from 1 to 5 (5 represents excellence) for Medicare Advantage plans. The federal agency evaluates Medicare Advantage health plans across the U.S. based on certain criteria. Star ratings for 2024, which are announced in October, are based on 42 quality measures if the plan includes drug benefits. Some of the quality measures evaluated include member adherence to statin therapies if they have cardiovascular conditions, member access to medical appointments, diabetic care, among other criteria. CMS’ 2024 ratings are based on 2022 data.
“We are immensely pleased that we obtained the highest possible rating, a 5, on preventive care (HEDIS), the quality care metrics for elderly adults and/or with chronic conditions, and our pharmacy benefits,” said Dr. José Novoa, Chief Medical Officer of Triple-S. “These are critical areas for the health of our members and without close collaboration with our providers and our members, we would not have been able to reach this level of excellence,” according to the physician.
“There are other areas on which we will continue to work to improve our members’ experience and their health,” said Novoa, one of them is improving timely access to medical appointments.
“The Triple-S Advantage HMO plan is a top quartile performer in the Stars program,” said Justice. “This is the result of the care we demonstrate daily in service to our members. We are deeply committed to the health of our members and the quality they receive in the health system.”
About Triple-S Advantage
Triple-S Advantage is a Health Maintenance Organization (HMO) and Preferred Provider (PPO) with a Medicare contract and a contract with the Government of Puerto Rico Health Plan (Medicaid). Enrollment in Triple-S Advantage Inc. depends on contract renewal. It is an independent licensee of the BlueCross and BlueShield Association in Puerto Rico, and part of Grupo Triple-S and subsidiary of GuideWell, the parent company of Florida Blue. Every year Medicare evaluates plans based on a rating system of 1-5 stars. Star Ratings are calculated each year and may change from one year to the next.