Maui Business

Kaiser Permanente Medicare Plan Earns Positive Federal Review

October 9, 2020, 11:15 AM HST
* Updated October 9, 9:56 AM
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For the fourth straight year, Kaiser Permanente Hawaiʻi has received 5 out of 5 stars from the Centers for Medicare and Medicaid Services for its 2021 Medicare plan. Kaiser Permanente is the only Medicare plan in Hawaii and one of just 21 in the nation to receive 5 stars this year from CMS, a federal agency and division of the U.S. Department of Health and Human Services.

The Medicare Star Quality Ratings for 2021 is based on plans’ performance in measures related to staying healthy, managing chronic conditions, member experience, customer service and pharmacy services. Once a year, CMS, the agency that oversees Medicare administration, assigns a rating to individual Medicare health plans ranging from 1 (lowest) to 5 (highest) stars to provide beneficiaries with a way to assess Medicare plans each contract year.

“We’re once again proud to be recognized as the leading Medicare plan in Hawaiʻi for providing the highest quality care and service to our kupuna members,” said Linda Puu, vice president of Quality, Safety and Care Experience at Kaiser Permanente Hawaiʻi. “Our integrated model of care, which is centered on patients, includes measures like preventive care and management of chronic conditions to keep our members healthy.”

Medicare health plans that earn 5 out of 5 stars can participate in a 5-star Special Enrollment Period and continue to enroll new individual Medicare members from Dec. 8 through Nov. 30 of the following year. Beneficiaries who want to change from their current Medicare health plan to a 5-star plan may switch once per plan year during the 5-star Special Enrollment Period.

Data for the Medicare star quality rating is drawn from the Healthcare Effectiveness Data and Information Set, the Consumer Assessment of Healthcare Providers and Systems, Health Outcomes Survey and CMS administrative data from audits, complaints and “secret shopping.”

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Due to the COVID-19 pandemic, previous year’s performance scores for select measures were factored into the 2021 ratings.

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