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, 2021

Prime 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

September 16, 2022

Sirtify cultivates Black male teachers to increase representation in K-12 classrooms

As enrollees in the Sirtify program, Black male students aspiring to be K-12…

Stories

September 12, 2022

Prime ranks No. 3 on list of Minnesota’s top private companies 

Prime Therapeutics (Prime) was among the top companies named by Minneapolis/St. Paul Business…

Stories

August 17, 2022

Giving Joy to Youth in Need

Who is the face of homelessness? One might think of a person on…