Rachelle KhalafDirector, Public Relations and Communications
KelseyCare Advantage is among an elite group of plans to have achieved a 5-out-of-5 star rating four years in a row, the highest possible rating for service and quality by CMS
HOUSTON (Oct. 15, 2019) – On Friday, Oct. 11, the Centers for Medicare and Medicaid Services (CMS) announced that KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area Medicare beneficiaries, earned 5-out-of-5 stars in an annual assessment of all Medicare Advantage plans for the fourth year in a row. This 5-out-of-5 star rating applies to the 2020 plan year which begins on Jan. 1.
Achieving five stars is challenging and is the highest overall rating for quality and service. Earning a 5-star rating is difficult in any given year, but to achieve this rating four years in a row puts KelseyCare Advantage in an elite class of healthcare organizations.
KelseyCare Advantage is the only 5-out-of-5 star rated Medicare Advantage plan in the Houston area for the 2020 plan year. No other Medicare Advantage plan achieved an overall 5-star rating in the Houston area.
"Being awarded 5-out-of-5 stars four years in a row demonstrates our commitment to excellence and providing our members with access to high quality medical care and exceptional customer service. What we do for our KelseyCare Advantage members is very special and is evident in the fact that we are one of three organizations in the entire country that offers a plan that has achieved a 5-out-of-5 stars rating four years in a row," said Marnie Matheny, President of KelseyCare Advantage. "Since 2008, KelseyCare Advantage has worked diligently to develop a Medicare Advantage plan worthy of the members who choose us to manage their care. We have always been focused on achieving a 5-star rating because our members deserve nothing less, and we will continue to work on developing programs and services that help improve outcomes while lowering cost."
Each year, Medicare uses information from member satisfaction surveys, clinical data, and healthcare providers to give overall performance ratings to Medicare health and prescription drug plans. These ratings help Medicare beneficiaries choose a plan based on quality and performance. A plan can earn from one to five stars. A 5-star rating is considered excellent. The 2020 overall plan rating is based on 40 healthcare and service quality measures, including detecting illness and keeping members healthy, managing chronic conditions, member satisfaction, and customer service.
"KelseyCare Advantage has seen considerable growth over the last several years as we now serve over 35,000 members. We attribute much of our growth to our commitment to providing a high quality medical experience. We know that patients in the Greater Houston area have many choices for where they receive care. The 5-star rating is an indicator that we just do it better," said Donnie Aga, M.D., Medical Director for KelseyCare Advantage. "The Kelsey-Seybold medical group and primary care affiliates provide a coordinated care model that is unmatched and fundamental to producing better patient outcomes. In addition, our patients receive outstanding local customer service. In 2020, KelseyCare Advantage will have the ability to serve even more patients by expanding our service area to nine additional counties."
KelseyCare Advantage has held a contract with Medicare since 2008 and currently serves more than 35,000. In 2020 KelseyCare Advantage has expanded its service area and is now offered in the 13 counties of Fort Bend, Harris, Montgomery, portions of Galveston, Austin, Brazoria, Chambers, Grimes, Liberty, San Jacinto, Walker, Waller, and Wharton. The plan is affiliated with Kelsey-Seybold Clinic, a group of doctors based in Houston who have been serving Houston-area families for 70 years.
KelseyCare Advantage plans provide all Medicare Part A and B coverage, and some plans include Part D prescription drug coverage to Houston-area Medicare beneficiaries who want more coverage than traditional Medicare provides. Additionally, KelseyCare Advantage offers four plans that have a point-of-service (POS) benefit which allows members the flexibility to see any provider that accepts traditional Medicare.
Medicare-eligible residents in these areas can enroll in a KelseyCare Advantage plan during the Medicare annual enrollment period between Oct. 15, 2019 and Dec. 7, 2019, with an effective date of Jan. 1, 2020. In addition to receiving high-quality care and exceptional customer service, 5-star excellence means that Medicare beneficiaries may enroll in a 5-star plan at any time between Dec. 8, 2019 and Nov. 30, 2020, without having to wait until the next annual enrollment period. If a Medicare beneficiary is enrolled in another Medicare Advantage plan, they may switch to the KelseyCare Advantage plan at any time without waiting for the next annual enrollment time period.
Every year, Medicare evaluates plans based on a 5-star rating system. To learn more about KelseyCare Advantage, or about the Medicare Star Quality Ratings, visit: www.kelseycareadvantage.com or www.medicare.gov, or call 1-800-MEDICARE (1-800-633-4227).
Kelsey-Seybold Clinic is Houston's premier multispecialty group practice, founded in 1949 by Dr. Mavis Kelsey in Houston's renowned Texas Medical Center. More than 650 physicians and allied health professionals practice at 36 locations in the Greater Houston area. Kelsey-Seybold offers quality medical care in 65 medical specialties. The organization operates the largest freestanding Ambulatory Surgery Center in the state of Texas and offers state-of-the-art Varian TrueBeam and Varian Edge radiation therapy technology at a nationally accredited Cancer Center. An accredited Sleep Center, comprehensive laboratory services, advanced imaging and diagnostics, 24 onsite Kelsey pharmacies and one specialty pharmacy, and MyKelseyOnline, a secure web portal, are part of its comprehensive offerings. Kelsey-Seybold partners with major insurers to offer value-based commercial health plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold Clinic, has achieved the coveted 5-out-of-5-star rating from the Centers for Medicare and Medicaid for seven consecutive years.
Kelsey-Seybold has been recognized by the National Committee for Quality Assurance (NCQA) as the nation’s first accredited Accountable Care Organization and a Patient-Centered Medical Home. Kelsey-Seybold has many physicians in the Greater Houston area certified for excellence in diabetes and heart and stroke care by the NCQA. In addition to these recognitions, Kelsey-Seybold is home to a nationally accredited Breast Diagnostic Center and Endoscopy Center.
Share This Article