{"id":111,"date":"2012-11-14T14:26:03","date_gmt":"2012-11-14T18:26:03","guid":{"rendered":"http:\/\/www.hnetalk.com\/Employer\/?p=111"},"modified":"2012-11-14T14:26:03","modified_gmt":"2012-11-14T18:26:03","slug":"hne-achieves-5-star-status-second-year-in-a-row","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/employer\/2012\/11\/14\/hne-achieves-5-star-status-second-year-in-a-row\/","title":{"rendered":"HNE Achieves 5-Star Status Second Year in a Row"},"content":{"rendered":"

\"\"And Maintains the Position of the Only<\/span> Health Plan in Massachusetts to be Rated as 5-Star<\/em><\/strong><\/p>\n

A 5\u2011star rating is Medicare\u2019s highest rating and reflects a plan\u2019s overall performance. Medicare determines a plan\u2019s overall performance rating based on information from member satisfaction surveys, HEDIS (quality effectiveness data) results, and CMS monitoring data. A plan can get a rating between one and five stars. These ratings help prospective members compare plans based on quality and performance.<\/p>\n

The overall score for quality<\/strong> covers both medical and pharmacy, and includes<\/strong> 53 different topics in 9 categories<\/strong>:<\/p>\n

    \n
  1. Staying healthy: screenings, tests, and vaccines<\/li>\n
  2. Managing chronic (long-term) conditions<\/li>\n
  3. Ratings of health plan responsiveness and care<\/li>\n
  4. Health plan member complaints and appeal<\/li>\n
  5. Health plan telephone customer service<\/li>\n
  6. Drug plan customer service<\/li>\n
  7. Drug plan member complaints and Medicare audit findings<\/li>\n
  8. Member experience with drug plan<\/li>\n
  9. Drug pricing and patient safety<\/li>\n<\/ol>\n

    Prospective members have the opportunity to switch to a 5-star plan at any time during the year by using a Special Enrollment Period (SEP), not just during the Annual Enrollment Period (AEP), which runs from October 15th<\/sup> through December 7th<\/sup>.\u00a0 HNE will actively market year-round to reach Medicare beneficiaries who would like to make a change after the AEP.<\/p>\n

    \u201cWe are extremely proud to achieve a second-year 5-star designation. HNE\u2019s quality program is comprehensive. It is focused on ensuring that high-quality, cost-effective care and services are provided to all <\/span>HNE members, regardless of the type of coverage they have with us. In addition to Medicare Advantage Plans, HNE offers Employer Group and Individual Health Plan options, and is a provider for MassHealth. With leadership from Pat Scheer, Director of Quality Operations, HNE has an annual quality improvement plan, a Quality Management Committee that guides our quality program, and several internal committees that manage the clinical and service quality improvement initiatives. This rating is a testament to all the hard work we do with our members and providers. I congratulate the entire organization for focusing on quality and achieving the best results possible,\u201d said Peter Straley, HNE president and CEO.<\/p>\n","protected":false},"excerpt":{"rendered":"

    And Maintains the Position of the Only Health Plan in Massachusetts to be Rated as 5-Star A 5\u2011star rating is Medicare\u2019s highest rating and reflects a plan\u2019s overall performance. Medicare determines a plan\u2019s overall performance rating based on information from member satisfaction surveys, HEDIS (quality effectiveness data) results, and CMS monitoring data. A plan can […]<\/p>\n","protected":false},"author":1,"featured_media":148,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[9],"tags":[],"class_list":["post-111","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-insidehne-nov-2012"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"http:\/\/hnetalk.com\/employer\/wp-content\/uploads\/2012\/11\/5Star.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZu3-1N","_links":{"self":[{"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/posts\/111","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/comments?post=111"}],"version-history":[{"count":0,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/posts\/111\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/media\/148"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/media?parent=111"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/categories?post=111"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/employer\/wp-json\/wp\/v2\/tags?post=111"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}