#Blue Shield #Medicaid #NCQA

Blue Shield of California Promise Health Plan Achieves 4-Star Rating for Quality

Blue Shield of California Promise Health Plan is thrilled to announce its fantastic achievement of a 4 out of 5 stars in the latest Medicaid Health Plan Ratings from the National Committee for Quality Assurance (NCQA) for the year 2025. For the second consecutive year, this notable rating highlights the plan's unwavering commitment to excellence in clinical quality and member experience.

Overview of Ratings

The NCQA evaluates health plans on a scale of 1 to 5 stars, with five being the highest. This year, only two Medi-Cal plans serving Los Angeles and San Diego counties earned a rating of 4 stars or above, positioning Blue Shield Promise among the elite in California’s Medicaid sector. It’s noteworthy that this plan maintained the same level of commendation in 2024, demonstrating consistent performance and quality.

Kristen Cerf, the President and CEO of Blue Shield Promise, remarked, "Our rating underscores our deep commitment to clinical quality, preventive care, and an exceptional member experience. Obtaining such high-performance metrics for two consecutive years reflects our dedication and the investments made to enhance care delivery for our Medi-Cal members."

Excellence in Preventive Care and Clinical Quality

The health plan excelled in two primary composite categories: Treatment and Prevention, as well as Population Health. These areas are pivotal in ensuring that members receive the high-quality care necessary to thrive at every stage of life.

In the Treatment category, Blue Shield Promise achieved an impressive 4.5 out of 5 stars. This high score is attributed to its commitment to supporting members dealing with behavioral healthcare and opioid use disorders. Notably, the plan has made significant strides in providing easy access to psychiatric services, allowing members to meet with their chosen providers at times that suit their schedules.

Furthermore, in the Prevention and Population Health category, the plan scored 4 out of 5 stars, particularly demonstrating strengths in child and adolescent care. This reflects a robust commitment to providing essential examinations through timely check-ups, pediatric vaccinations, and other preventive services that support healthy growth while eliminating access barriers for families.

Background on Blue Shield of California Promise Health Plan

Blue Shield of California Promise Health Plan is a managed care organization exclusively owned by Blue Shield of California. The plan is directed by healthcare professionals who live by a