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KP Medicare Plans Get Top National Rating

KP Health plans in California are recognized with the maximum 5-star rating by the Centers for Medicare & Medicaid Services for excellence in care and service.

Kaiser Permanente’s Medicare plans in California have received an overall rating of 5 stars for parts C and D, the highest rating possible in the 2016 Medicare star quality ratings from the Centers for Medicare & Medicaid Services (CMS). This is the fifth consecutive year that CMS has given the California health plan its top national rating.

“Kaiser Permanente’s consistently high quality scores in the CMS star ratings and other national health care surveys go hand-in-hand with our leadership role in reshaping American health care,” said Gregory A. Adams, group president and regional president of Kaiser Foundation Hospitals and Health Plan, Inc., in Northern California. “Our high-quality care and a focus on prevention are keeping people healthier and often preventing illnesses and disease from occurring in the first place.”

CMS’ Medicare star quality rating system provides beneficiaries a way to assess the quality of care and service delivery of Medicare plans, so they can make an informed decision when choosing a plan. CMS uses the star ratings to rank Medicare plans on a scale of 1 to 5 stars, with 5 stars representing the highest quality. The overall scores are based on approximately 50 care and service quality measures (Parts C and D) across nine categories that include staying healthy, managing chronic conditions, member satisfaction, customer service, and pharmacy services.

The number of measures used varies by the health plan, and from year to year. For 2016, CMS based overall scores for each plan on up to 44 unique measures. Besides care and service quality, the star ratings also reflect health plans’ compliance performance. CMS’ methodological changes and improvements among all Medicare plans continue to raise the bar on the level of performance required to achieve 5 stars.

Kaiser Permanente Medicare plans have consistently received high ratings since CMS began tracking them in 2009. One reason is Kaiser Permanente’s integrated care model, which enables its staff and care teams to serve members and patients using a coordinated, seamless system that promotes a total health approach. A core feature of this model is Kaiser Permanente’s electronic health records system that its physicians, nurses, and other providers use to safely and efficiently provide high-quality care, connecting with patients and members wherever they are. This technology also enables customer service agents, health plan representatives, call center operators, and other administrative and pharmacy staff to better assist and support members, leading to the superior service and satisfaction ratings from CMS.

“The 5-star Medicare rating, combined with the recently released quality ratings from the National Committee for Quality Assurance and our consistently high rating by the California Office of the Patient Advocate, demonstrates the superiority of the health care we provide at Kaiser Permanente,” said Robert Pearl, MD, executive director and CEO of The Permanente Medical Group. “Our physicians, nurses, and staff provide medical care that is personalized, technologically advanced, and closely coordinated across both inpatient and outpatient settings.”

In addition to recognition by CMS, Kaiser Permanente Medicare plans’ quality excellence was recently highlighted by the National Committee for Quality Assurance report, “NCQA’s Health Insurance Plan Rankings 2015-16.” For the fourth year in a row, all seven Kaiser Permanente Medicare plans are the highest-rated in the markets they serve. And out of nearly 400 Medicare plans in the nation, only nine received the highest possible NCQA rating — and five of those are Kaiser Permanente plans that include Northern and Southern California.

For Medicare beneficiaries, the advantages of a 5-star plan go beyond high-quality care and service — they also include a longer enrollment opportunity. Medicare beneficiaries may switch to a 5-star Kaiser Permanente individual Medicare plan through a CMS Special Enrollment Period from Dec. 8, 2015, to Nov. 30, 2016, without having to wait until the next annual enrollment period. All available Kaiser Permanente physicians welcome Kaiser Permanente Medicare health plan members. Medicare beneficiaries can learn more about the star ratings and Kaiser Permanente’s Medicare plans by visiting

Medicare evaluates plans based on a 5-star rating system. Star ratings are calculated each year and may change from one year to the next.




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