Blue Shield of California Promise Health Plan Achieves 4-Star Rating from NCQA
In a significant milestone for healthcare quality, the Blue Shield of California Promise Health Plan has been awarded a prestigious 4-star rating by the National Committee for Quality Assurance (NCQA) for its Medicaid Health Plans. This recognition places Blue Shield Promise among the top-ranked commercial Medi-Cal plans in California, reflecting its commitment to delivering high-quality care to its members.
A Commitment to Quality Care
The NCQA’s annual ratings evaluate health plans based on various criteria, including patient experience, clinical quality, and member satisfaction. The 2024 Health Plan Ratings, which are based on data from 2023, utilize a star rating system ranging from 1 to 5, with 5 being the highest. Blue Shield Promise has made a notable leap from a previous score of 3.5 stars to 4 stars, indicating substantial improvements in its service delivery.
Kristen Cerf, the president and CEO of Blue Shield Promise, expressed pride in this achievement, stating, “We’re tremendously proud of earning this rating that recognizes all the work we’ve done to make our members’ health even better.” This sentiment underscores the organization’s dedication to not only providing care when members are ill but also ensuring they have access to preventive services that promote long-term health.
Focus on Preventive Services
One of the standout features of Blue Shield Promise’s approach is its emphasis on preventive care. The health plan has implemented various initiatives aimed at disease prevention, including well-child visits and screenings for breast and cervical cancer. These services are crucial in identifying health issues early and providing timely interventions, which can significantly improve health outcomes.
The NCQA rating reflects the effectiveness of these initiatives, as they contribute to higher member satisfaction and better overall care. Cerf highlighted the importance of these services, stating that they are essential for ensuring that Medi-Cal members receive comprehensive care that addresses both immediate health needs and long-term wellness.
Enhancing Member Experience
Blue Shield Promise has made significant strides in enhancing the member experience. The organization has focused on improving engagement with its members to ensure that their diverse needs are met. This includes offering appointment scheduling services, referral assistance, and educational resources about the various programs available to members.
Moreover, the health plan has prioritized access to care, recognizing that many members face barriers in obtaining necessary services. For instance, women needing mammograms often encounter difficulties accessing these critical screenings. In response, Blue Shield Promise has established mobile mammogram clinics that operate in community settings and on weekends, making it easier for working mothers to participate.
Expanding Telehealth Services
In addition to mobile clinics, Blue Shield Promise has expanded its telehealth services, allowing members to consult with healthcare providers from the comfort of their homes. This innovation is particularly beneficial for individuals who may have transportation challenges or those living in areas with limited access to healthcare providers.
Cerf noted, “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.” By leveraging technology and community partnerships, Blue Shield Promise is working to ensure that all members can access the care they need, regardless of their circumstances.
Future Goals and Commitment
Looking ahead, Blue Shield Promise remains committed to continuous improvement. The organization plans to focus on enhancing access to care and increasing engagement with healthcare providers. By collaborating with providers, Blue Shield Promise aims to better understand their needs and equip them with the necessary resources to deliver optimal care to members.
Cerf emphasized the hard work that has gone into achieving the 4-star rating, stating, “We worked extremely hard this past year to improve upon our performance, and that hard work is paying off to benefit our members.” This commitment to excellence reflects the organization’s mission to build a healthcare system that is not only effective but also sustainably affordable for families and communities.
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, dedicated to providing Medi-Cal services. With a "members-first" philosophy, the health plan is led by healthcare professionals committed to building a quality network of providers and partnering with community organizations. Serving over 530,000 members across Los Angeles and San Diego counties, Blue Shield Promise continues to focus on improving health outcomes and member satisfaction.
For more information about Blue Shield of California Promise Health Plan, visit www.blueshieldca.com/promise. For the latest news, follow Blue Shield of California on LinkedIn and Facebook.