Stories
30 Prime-supported Medicare contracts earn quality bonuses
92% of Prime-supported Medicare Advantage members will be in contracts that earned a quality bonus payment from CMS
November 16, 2021Prime Therapeutics (Prime) helped 30 of its Medicare Advantage Prescription Drug (MAPD) contracts, representing 92% of MAPD membership, receive a quality bonus payment for earning four stars or more in the ratings released by the Centers for Medicare and Medicaid Services (CMS). This includes five contracts that achieved a 5-Star overall rating, and 10 new contracts that earned a quality bonus payment compared to last year.
Stars and total drug management
As a pharmacy benefit manager, Prime influences many of the Star rating measures across:
- Operations
- Customer experience
- Medication adherence and clinical management
Prime helped improve our plans’ ratings for Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, which are highly weighted measures in determining overall ratings. These member surveys include an overall rating of the drug plan, and how easy it is for the member to get needed prescriptions.
“These ratings show that Prime is contributing to improving the quality of health care, while at the same time making health care more affordable and accessible to Medicare members,” says Kim Kishel-Geiger, senior director, quality management. “Each year favorable ratings become more difficult to achieve because the bar is continually raised, so we must continue to be innovative.”
Related news
Stories
May 25, 2022
Three Minutes with Kelly Pokuta
Dr. Kelly Pokuta is vice president, trade relations & strategy and chief trade…
Stories
May 23, 2022
Biosimilar use alone won’t cut drug costs
We see it time after time. High-potential innovation that just doesn’t seem to…
Stories
May 13, 2022
Prime expert showcases medical specialty drug management solutions
Prime Therapeutics’ (Prime) Chris Ford, assistant vice president, strategy and innovation, was a…