OAKLAND, Calif. — “I’m on bonus time, there’s absolutely no question about that,” said George Wittemyer, reflecting on the care he received from physicians and nurses during an emergency cardiac event and subsequent surgery. “And I’m really happy. Here I am, thanks to Kaiser Permanente.”
Wittemyer’s experience of seamless care, expert medicine and top-notch service represents one of the many reasons the organization’s Medicare health plans have once again received high scores by the Centers for Medicare & Medicaid Services.
In CMS’ Oct. 11 announcement of the 2018 Medicare star quality ratings, Kaiser Permanente’s Medicare health plans in Northern and Southern California, Colorado, Hawaii, Northwest and Mid-Atlantic States received 5 out of 5 stars each. Kaiser Permanente in Georgia and Washington earned 4.5 out of 5 stars.
According to CMS, Kaiser Permanente represents five of 15 Medicare health plans (with Parts C and D) that earned 5 out of 5 stars, the highest overall rating. Moreover, of the nearly 2 million beneficiaries enrolled in those 5-star plans nationwide, 72 percent are Kaiser Permanente Medicare members. Wittemyer is one of more than 1.5 million Medicare beneficiaries who rely on Kaiser Permanente for high-quality health care with service that is convenient, personalized and simple to use.
Wittemyer, 77, a Kaiser Permanente Medicare health plan member in Portland, Oregon, knew something was wrong when after increasing episodes of weakness and shortness of breath, he could hardly walk up his driveway. Thanks to quick action by his internist, Wittemyer was soon in urgent care for treatment, and then conferring with his physicians about surgery to attach a left ventricular assist device, or “LVAD,” to his heart.
After much discussion and deliberation, Wittemyer made the decision with his doctors to proceed with the surgery. Surgery and recovery were both a success, and Wittemyer credits his entire care team — including his “peerless” surgeon, “marvelous” physicians and “incredible” nurses — with providing expert care and support throughout his experience.
Perhaps because he grew up on a working farm, Wittemyer calls his LVAD “the turbine.” With his new turbine in place, Wittemyer is back to driving his tractor, chopping trees and doing other chores on his acreage. “I’m back to being a normal person,” he said, smiling.
“By providing excellent, compassionate care, our physicians and care teams are helping our members achieve and maintain total health,” said Michael Kanter, MD, executive vice president of quality and chief quality officer for The Permanente Federation, the national organization for more than 21,000 physicians who provide care to Kaiser Permanente’s 11.8 million members. “Our patients partner with their doctors to make personalized treatment decisions together so they can live full, active lives. The CMS ratings reflect the success of our person-centered approach to delivering safe and effective care.”
As the nation’s largest integrated health system, Kaiser Permanente connects its care teams to members via digital tools, technology and a range of care settings so that members can access care whenever and wherever they need.
Kaiser Permanente Medicare plans have consistently received high ratings since the Centers for Medicare & Medicaid Services began the Medicare stars program, and have maintained high performance in all states in which the health plan operates. For CMS’ 2018 star ratings:
- Kaiser Permanente Colorado received the highest possible rating of 5 out of 5 stars for the eighth year in a row.
- Kaiser Permanente Northern and Southern California received the highest possible rating of 5 out of 5 stars for the seventh year in a row and is the highest rated plan in the state.*
- Kaiser Permanente Northwest, which includes Oregon and southwest Washington, received the highest possible rating of 5 out of 5 stars for the seventh year in a row.
- Kaiser Permanente Mid-Atlantic States, which includes Maryland, Virgina and Washington, D.C., received the highest possible rating of 5 out of 5 stars for the sixth year in a row.
- Kaiser Permanente Hawaii received the highest possible rating of 5 out of 5 stars and is the highest rated plan in the state.
- Kaiser Permanente Georgia received 4.5 out of 5 stars.
- Kaiser Permanente Washington received 4.5 out of 5 stars.
*Northern and Southern California regions rated together as they represent one CMS contract.
A rating system to make choice easier
CMS created the Medicare star quality rating system to provide beneficiaries with a way to assess Medicare plans based on quality of care and service delivery, so they can make an informed decision when choosing a plan. CMS uses the star ratings system to rank Medicare health plans on a scale of 1 to 5 stars, with 5 stars representing the highest quality.
Kaiser Permanente Medicare health plans have consistently received high ratings since CMS began awarding them in 2009.
“Our high star ratings year after year reflect the dedicated work of providers and staff throughout our organization to ensure the best care and service experience for our members,” said Patrick Courneya, MD, executive vice president and chief medical officer for Kaiser Foundation Health Plan and Hospitals. “Kaiser Permanente’s integrated model enables a seamless, coordinated care experience for members, and our commitment to evidence-based practices and prevention measures means we are our patients’ partner in becoming their healthiest selves.”
A leader in quality
Kaiser Permanente’s high rating by CMS is the latest of several quality recognitions the organization has achieved this year. In the “NCQA Health Insurance Plan Ratings 2017-2018” report, the National Committee for Quality Assurance lists all seven Kaiser Permanente Medicare plans as the highest rated or ranked, or tied-for-highest, in the markets they serve — for the sixth year in a row. And for the fifth consecutive year, Kaiser Permanente’s Medicare website, kp.org/Medicare, was rated one of the top Medicare websites in the nation for providing consumers with an easy, positive and high-value experience.
Medicare beneficiaries can learn more about the star ratings and Kaiser Permanente’s Medicare health plans by visiting kp.org/medicarestars.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 11.8 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.
Fast facts: Medicare quality stars
What they measure: The overall scores for Medicare quality stars are based on care and service quality measures (Parts C and D) across nine categories, including staying healthy, member satisfaction, managing chronic conditions, customer service and pharmacy services. The star ratings also measure health plans’ compliance performance.
Methodology: Star ratings are calculated each year and may change from one year to the next. The methodology CMS uses for the star ratings is dynamic and continues to change. This means that Medicare health plans must stay ahead of the curve on measures that may be included in the 5-star portfolio, and continually improve their performance to achieve 5 stars.
Special enrollment opportunity: Along with high-quality care and service, another benefit of 5-star plans is a longer enrollment opportunity. Medicare beneficiaries may change to a 5-star Kaiser Permanente individual Medicare plan through a CMS 5-star Special Enrollment Period from Dec. 8, 2017, to Nov. 30, 2018, without having to wait until the next annual enrollment period.