Blue Shield of California Promise Health Plan Earns 4-Star Rating From The National Committee for Quality Assurance

Nonprofit health plan rated among the top in California for patient experience and clinical quality

OAKLAND, Calif., Sept. 19, 2024 /PRNewswire/ — The National Committee for Quality Assurance (NCQA) for Medicaid Health Plans awarded a coveted 4-star rating to the Blue Shield of California Promise Health Plan, making it one of the highest-ranked commercial Medi-Cal plans in the state. Blue Shield Promise earned high scores in a number of key areas including disease prevention, overall care and member satisfaction.

“We’re tremendously proud of earning this rating that recognizes all the work we’ve done to make our members’ health even better,” said Kristen Cerf, president and CEO of Blue Shield Promise. “That means ensuring that our Medi-Cal members get great care when they are sick and also have access to resources to keep them healthy with critical preventative services such as well child visits and breast and cervical cancer screenings.”

The annual list evaluates commercial, Medicare and Medicaid health plans based on assessments of patient experience and clinical quality. The 2024 Health Plan Ratings are based on data from calendar year 2023. Health plans are rated on a scale of 1– to 5 stars with 5 as the highest rating. Promise Health Plan previously scored 3.5 stars, moving up a full half star in the latest assessment.

“Annual Health Plan Ratings are vital to providing health care consumers with transparent and objective information about the quality and performance of health plans,” said Margaret E. O’Kane, president of NCQA. “Ratings not only help individuals make informed choices to receive the best possible care but also motivate health plans to improve their operations, with a focus on quality, equity and accountability.”

Focus on Member Experience, Access to Preventive Care

Blue Shield Promise has been focused on improving the experience of its members in a variety of ways, including enhanced engagement to ensure the membership’s diverse needs are met. Among them: appointment scheduling service and referral assistance as well as education on a wide range of programs and services the health plan offers its members to help them get healthy and stay healthy.

The nonprofit health plan also placed strong emphasis on improving access to care, developing and expanding programs to bring care closer to where members live or work, and outside of traditional clinical settings. For example, many women who need mammograms cannot easily access this potentially life-saving scan. Blue Shield Promise teams worked to set up mobile mammogram clinics in the community, and on weekends, to make it easier for working mothers to participate. The health plan also expanded its telehealth services so members can consult with a provider without having to leave the comfort of their home.

“Our members can face many challenges when it comes to their health care – from hectic work and childcare schedules to living in areas where there is a scarcity of providers,” Cerf said. “We’re continuing to work with community-based organizations and develop new ways of bringing care to people where they are and make sure all our members can get the care they need.”

Blue Shield Promise remains committed to continued improvements in the coming year by focusing on improving access and increasing engagement with providers, working alongside them to better understand what they need to provide members with the best care, necessary resources and support.

“We worked extremely hard this past year to improve upon our performance, and that hard work is paying off to benefit our members,” Cerf said. “We still have more we want to achieve, but we are proud of the results of our efforts. This is what we mean when we say we are committed to building a health care system worthy of our family and friends that is sustainably affordable.”

About Blue Shield of California Promise Health Plan
Blue Shield of California Promise Health Plan is a managed care organization, wholly owned by Blue Shield of California, offering Medi-Cal. It is led by healthcare professionals with a “members-first” philosophy and committed to building a quality network of providers and partnering with community organizations for more than 530,000 members across Los Angeles and San Diego counties. For more information about Blue Shield of California Promise Health Plan, please visit www.blueshieldca.com/promise. For more news about Blue Shield of California, please visit news.blueshieldca.com. Or follow us on LinkedIn, Twitter, or Facebook.

CONTACT: Mark Seelig
Blue Shield of California Promise Health Plan
510-607-2359
[email protected]

SOURCE Blue Shield of California Promise Health Plan