San Juan, PR — Triple-S Management Corporation (NYSE: GTS), a leading managed care company in Puerto Rico, announced today that its 2019 Care Coordination Medicare Advantage HMO contract (H5774) has received an overall 4.5-star quality rating from the Centers of Medicare and Medicaid Services (“CMS”) out of a maximum possible rating of 5 stars. The new score is an upgrade from its previous 4-star rating and will apply in the payment year 2020. Approximately 88% of Triple-S’s Medicare Advantage membership participates in its HMO offering.
Specifically, Triple-S’ HMO offering (H5774) maintain its 5-stars rating in Part D. Abarca partners with Triple-S as its official pharmacy benefit management for their Medicare Advantage plans and manages its Part D strategy.
“We have consistently highlighted that achieving a higher rating is a vital strategic objective because it enhances our ability to retain and grow our membership.” said Roberto Garcia-Rodriguez, President and CEO of Triple-S. “The upgrade is a culmination of the tireless efforts over the past several years of our entire managed care team, led by Madeline Hernández-Urquiza, to ensure that providers have the tools to proactively address our members’ gaps in care.”
The executive added that Triple-S continues to innovate both in its models of care as well as in technological solutions to allow providers quick access to members’ health information to make better decisions about a patient’s needs.
CMS’ stars rating reflects the quality of care a member receives and the member’s satisfaction with his or her health carrier. The rating measures such factors as preventive care, hospital readmissions, adherence to medications, and the management of chronic conditions.
Triple-S Management Corporation is an independent licensee of the Blue Cross Blue Shield Association.