PQA Presents Quality Awards to 25 Medicare Plan Contracts for High Achievement in Medication Quality Measures


Awards honor excellence and improvement in overall CMS Medicare Star Ratings and PQA Medication Measures.

The Pharmacy Quality Alliance (PQA) has recognized 25 Medicare plan contracts with a PQA Laura Cranston Excellence in Quality or Quality Improvement Award for high achievement or significant improvement in PQA measures of medication safety and appropriate use.

The awards are based on the published CMS 2022 Medicare Part D Star Ratings. This is the PQA awards’ 12th year and the most plans ever recognized. Only 2.9% of the 850 Medicare Part D plan contracts qualified for an award.

The Excellence in Quality Award recognizes Medicare Advantage Drug Plans (MAPD) and Prescription Drug Plans (PDP). MAPDs are recognized for achieving at least a 4.5-star Part D summary rating and a 5-star rating on all five PQA measures used in the 2022 CMS Star Ratings program. PDPs are recognized for achieving at least a 4.5-star Part D summary rating and at least a 4-star rating on all five PQA measures used in the 2022 CMS program.

The Quality Improvement Award recognizes MAPDs and PDPs that received a 5-star rating on the 2022 CMS Quality Improvement measure and the greatest combined improvement in star ratings from 2021 to 2022 on the five PQA medication measures used in the CMS program during this period.

“The safe and effective use of medications is a high priority for care providers and the Medicare Part D program,” PQA Chief Executive Officer Micah Cost, PharmD, MS, said. “PQA is proud to recognize 25 plans this year. These awards are a tangible recognition of their commitment to excellence and dedication to providing high-quality care for their Medicare members.”

This year’s quality awards recipients, presented to the plan’s parent organization, are:

Excellence in Quality Award – MAPDs (CMS Contract Number and Name)

  • Alignment Healthcare USA, LLC (H3815 - Alignment Health Plan)
  • Cigna (H5410 - Cigna)
  • Devoted Health, Inc. (H7993 - Devoted Health)
  • Humana (H1019 - CarePlus Health Plans, Inc.)
  • Kaiser Foundation Health Plan, Inc. (H2172 - Kaiser Permanente Mid-Atlantic States)
  • Kaiser Foundation Health Plan, Inc. (H0524 - Kaiser Permanente Northwest)
  • Kaiser Foundation Health Plan, Inc. (H9003 - Kaiser Permanente Northern and Southern California)
  • South Country Health Alliance (H2419 - South Country Health Alliance)
  • Stonerise Senior Advantage Holdings, LLC (H9153 - West Virginia Senior Advantage)
  • UNICO Premier, LLC (H3291 - PruittHealth Premier)

Excellence in Quality Award – PDPs (CMS Contract Number and Name)

  • Anthem Insurance Co. & BCBSMA & BCBSRI & BCBSVT (S2893 - Blue MedicareRx)
  • Commonwealth of PA Pub Schools Retirement System (E3014 - PSERS Health Options Program)
  • HealthPartners, Inc. (S1822 - HealthPartners)
  • Highmark Health (S1140 - Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York)
  • Independence Health Group, Inc. (S6875 - Independence Blue Cross)
  • Independent Health Association, Inc. (S4501 - Pharmacy Benefit Dimensions PDP)
  • Moda Partners, Inc. (S5975 - Moda Health Plan, Inc.)
  • MVP Health Care, Inc. (S0586 - MVP Health Care)
  • Point32Health, Inc. (S0655 - Tufts Health Plan)
  • SSM Health Care Corporation (S9701 - Navitus MedicareRx)
  • The Carle Foundation (S4219 - Health Alliance Medicare Prescription Plan)
  • UPMC Health System (S3389 - UPMC Health Plan)

Quality Improvement Award – MAPDs (CMS Contract Number and Name)

  • Athena Healthcare Holdings, LLC (H0982 - Solis Health Plans)
  • Blue Cross Blue Shield of Arizona (H5587 - Health Choice Arizona)

Quality Improvement Award – PDPs (CMS Contract Number and Name)

  • Mutual of Omaha Insurance Company (S7126 - Mutual of Omaha Rx)

Five PQA-endorsed quality measures are used in the 2022 Medicare Part D Star Ratings program, and several others are used as Display measures. Details on these measures are available at pqaalliance.org/medicare-part-d. CMS evaluates Medicare plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. More information about Star Ratings can be found at Medicare.gov.

The awards were named in Cranston’s honor in 2020 in recognition of her 15 years of service as PQA’s founding CEO and contribution to medication quality. They were announced today at a recognition lunch during the 2022 PQA Annual Meeting in Baltimore, Md.


SOURCE: Pharmacy Quality Alliance

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