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ACHP Member Plans Excel in Quality Ratings for 2027

The latest ratings from the Centers for Medicare and Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA) showcase the exceptional performance of member companies of the Alliance of Community Health Plans (ACHP). These organizations have consistently achieved high ratings in quality metrics, which reflects their commitment to providing outstanding coverage in Medicare, Medicaid, and commercial health plans.

Star Ratings Overview

In the recently released 2027 Medicare Advantage Star Ratings, ACHP member plans achieved an impressive average of 4.23 stars, significantly surpassing the average of 3.96 stars for non-ACHP carriers. Notably, approximately 87% of enrollees in ACHP member plans are in contracts rated at least 4 stars, contrasting with around 69% enrolled in non-ACHP alternatives. This data emphasizes the superior quality of care provided by ACHP plans, especially in managing chronic health conditions.

Among these standout plans are Peak Health and Kaiser Permanente, both achieving the coveted 5-star rating for the upcoming year. Ben Gerber, CEO of Peak Health, remarked on this achievement, stating, "Earning five stars, as one of only 15 plans nationwide, shows what's possible when a plan and clinicians work hand-in-hand for the people we serve."

Clinical Care Management Success

The excellence of ACHP members is not solely reflected in their ratings but also in specific health management metrics. The ratings indicate significant achievements in areas such as cholesterol management, diabetes care, kidney problem detection, and minimizing risks associated with chronic diseases. The commitment to quality healthcare is further illustrated in ACHP’s strong performance across other categories as well:

• - Medicare: Four out of the five 5-star contracts received, with an average score of 3.96 stars.
• - Medicaid: All four contracts achieved 5-star ratings, with an average of 4.08 stars.
• - Commercial Coverage: Five out of nine contracts earned 5 stars, averaging 4.18 stars.

Advocacy for Quality Improvement

The ratings success aligns with ACHP's advocacy efforts on behalf of quality-driven healthcare standards. ACHP has actively participated in reforming quality measurement protocols, ensuring that the focus is on metrics that genuinely impact patient health outcomes. The introduction of the MA STARS Act by Rep. Mike Kelly aims to modernize Medicare Star Ratings to better reflect the nuances of quality and patient experiences, signaling a forward-thinking approach to health plan evaluation.

Alliance President and CEO Ceci Connolly emphasized the importance of these initiatives, stating, "Patients and employers deserve clear evidence of quality when choosing coverage. These ratings demonstrate the value of health plans rooted in the communities they serve."

The Bigger Picture

The ACHP's strategic emphasis on partnership between health plans and clinicians cultivates a high-quality healthcare ecosystem that meets the diverse needs of patients. This partnership model is essential in maximizing the delivery of efficient, innovative care to millions of Americans, particularly as the healthcare landscape continues to evolve.

By prioritizing quality and transparent metrics, ACHP members are setting a benchmark for what healthcare should represent—a collaborative, patient-centered approach that empowers individuals in managing their health effectively while ensuring that evaluation of care is genuinely meaningful. As health plans strive for excellence, the results reaffirm the dedication of ACHP member companies to uphold community health care standards that serve as a model for the entire industry.