Two Prime Medicare clients win PQA quality award

Pharmacy Quality Alliance (PQA) has recognized Prime clients Alignment Health Plan (AHP) and Florida Blue with a quality award for excellence. This is the third year in a row that AHP has been recognized; the second year for Florida Blue.

Only 24 Medicare contracts in the entire country received this quality award, out of 400 eligible contracts.

AHP and Florida Blue earned a perfect 5 Stars (out of 5 Stars) for their Part D ratings, and for each of these PQA medication measures:

• Diabetes medication adherence
• High cholesterol medication adherence
• High blood pressure adherence
• Medication therapy management
• Statin use in persons with diabetes

What this award means for AHP and Florida Blue

“This award says a lot about AHP and Florida Blue,” says Lilian Vu, regional director, client engagement. “It highlights their commitment to quality and continuous improvement. And it also means that among Prime’s Medicare clients, they are typically the first in line to pilot innovative new programs from Prime. They are always looking to improve.”

“Helping our plans achieve superior Star ratings is one of the ways Prime supports making health care more affordable for Medicare members across the country,” adds Jason Moore, regional director, client engagement.

What high Star ratings mean for Prime-supported Medicare contracts

It’s not surprising that these PQA Awards went to AHP and Florida Blue. Both plans also have high Star ratings from the Centers for Medicare and Medicaid Services (CMS). But they aren’t alone. A total of 19 Prime-supported Medicare contracts earned quality bonus payments based on the 2020 Star ratings released by CMS.

“The quality bonus payments from Star ratings add up to hundreds of millions of dollars. Our health plan clients can use these dollars to improve benefits and/or reduce costs to their members,” explains Rachel Nelson, vice president and general manager of federal programs.

About PQA

PQA is a nonprofit membership organization. It is committed to improving health care quality and patient safety. It develops strategies for measuring and reporting medicine performance.