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 three years in a row, the highest possible rating for service and quality by CMS
Houston (October 19, 2018) – On Oct. 10, 2018, 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 third year in a row. This 5-out-of-5 star rating applies to the 2019 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 three 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 Texas for the 2019 plan year. No other Medicare Advantage plan achieved an overall 5-star rating.
“KelseyCare Advantage celebrated 10 years of delivering high-quality care to members this year. Our plan has a track record of excellence with CMS who rated us 4.5-out-of-5 Stars five times and 5-out-of-5 Stars four times in the past 10 years. We make it our priority to focus on member experience and we partner with Kelsey-Seybold Medical Group to deliver high quality medical care and exceptional customer service to our members,” said Marnie Matheny, President of KelseyCare Advantage. “Being awarded 5-out-of-5 stars for a third year in a row is meaningful because it is reflective of the effort and focus we have on providing our Medicare Advantage plan members a plan that is patient-centered, high-quality and value-driven. What we do for our KelseyCare Advantage members is very special – and that is made clear because we are one of three organizations in the entire country that offers a plan that achieved a 5-out-of-5 stars rating three years running.”
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 2019 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.
“Ten years ago, there was much uncertainty in the healthcare industry. One thing we knew to be true was our group could provide a high level of personalized care to Medicare-eligible patients, and that in doing so, improve outcomes and manage care for them. It’s the reason why we established KelseyCare Advantage in 2008 and since then, we’ve maintained a 4-to-5-star CMS rating,” said Donnie Aga, M.D., Medical Director for KelseyCare Advantage. “We started with 2,200 members in 2008 – that number has grown exponentially to over 33,000 members today. This kind of growth is a testament to our commitment to better quality, improved health, and lower cost.”
KelseyCare Advantage has held a contract with Medicare since 2008, and currently serves more than 33,000 Texans in the counties of Fort Bend, Harris, Montgomery and portions of Galveston. The plan is affiliated with Kelsey-Seybold Clinic, a group of doctors based in Houston that have been serving Houston-area families for 69 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 two plans that have a point-of-service (POS) benefit which allow 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, 2018 and Dec. 7, 2018, with an effective date of Jan. 1, 2019. 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, 2018 and Nov. 30, 2019, 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.
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