Lisa Hines, PharmD
Senior Director, Measure Operations & Analytics
Pharmacy Quality Alliance
PQA Recognizes Ten Medicare Plan Contracts for Excellence and Significant Improvements in Medication-Use Quality
Awards Based on CMS' Medicare Star Ratings
(May 17, 2018) -
The Pharmacy Quality Alliance (PQA), a non-profit leader in quality measure development, today announced that ten Medicare plan contracts received PQA Quality Awards for high achievement or significant improvement in PQA measures of medication safety and appropriate use.
For the past eight years, PQA has recognized health plans for achievements during its Annual Meeting. This year eight plans received the PQA Excellence in Quality Award, one plan received PQA's Quality Improvement Award and another plan received both the PQA Excellence in Quality Award and the PQA Quality Improvement Award.
The 2018 PQA Excellence in Quality Award recognizes the highest level of combined achievement in overall performance and medication-use quality. Recipients achieved an overall summary rating of at least 4.5 stars and a 5-star rating on all four PQA medication measures used within the CMS Medicare Part D Star Ratings program.
This year's Excellence in Quality Award recipients are:
- Alignment Health Plan (Alignment Healthcare);
- Anthem Health Plans of New Hampshire (Anthem Blue Cross and Blue Shield);
- Care Wisconsin Health Plan;
- Dean Health Plan (Dean Advantage);
- Group Health Plan (HealthPartners);
- HealthSpring of Florida (Leon Medical Centers Health Plans);
- Kaiser Foundation Health Plan (Hawaii Region);
- Kaiser Foundation Health Plan of the NW (Northwest Region); and
- Tufts Insurance Company (Tufts Health Plan).
The 2018 PQA Quality Improvement Award recognizes the highest improvement in medication safety and appropriate use. The Quality Improvement Award does not take into consideration the plan's overall summary rating. Instead, recipients received a 5-star rating on the 2018 CMS Quality Improvement measure and the greatest combined improvement on PQA measures used in the CMS Medicare Part D Star Ratings program from 2017 to 2018. This year's award recipients are:
- Alignment Health Plan (Alignment Healthcare) and
- Health Alliance Medical Plans (Health Alliance Medicare).
"These awards are unique in that they are based solely on publicly available quality scores," said
, chief executive officer of PQA. "The effective use of medications is a top priority for all care providers, and it is extremely important in the Medicare Part D program. The excellence and improvement set forth in the criteria for these two distinct awards are achieved through careful and deliberate strategies, and interventions executed by the plans and their partners in the medication management of Medicare beneficiaries."
Four PQA-endorsed quality measures are used in the 2018 Medicare Part D Star Ratings program, and several others are used as Display measures. Details on these measures are available at
CMS evaluates Medicare plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. More information about Star Ratings can be found at
The Pharmacy Quality Alliance (PQA) is a non-profit organization committed to
optimizing health by advancing the quality of medication use. PQA, a recognized leader in quality measure development, is dedicated to improving the safe and appropriate use of medications, researching the impact of quality measurement, and providing education on quality-based healthcare. Established in 2006, PQA is a transparent, consensus-based, multi-stakeholder organization representing over 230 member organizations including healthcare payers, health plans, community pharmacies, physician providers, life sciences organizations, state and federal government agencies, academic institutions, standard setting/accreditation organizations, health information technology (HIT) partners, and other stakeholders interested in improving the quality of the medication-use system. For more information, please visit
About Alignment Healthcare
With offices and care centers across the country, Alignment Healthcare provides partners and patients with customized care and service where they need it and when they need it, including clinical coordination, risk management and technology facilitation. Alignment Healthcare offers HMO plan options to California residents through the Alignment Health Plan, and partners with select health plans in North Carolina and Florida to help deliver better benefits at lower costs. For more information, please visit
About Anthem Blue Cross and Blue Shield
Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. Independent licensees of the Blue Cross and Blue Shield Association. Additional information about Anthem Blue Cross and Blue Shield in New Hampshire is available at
About Care Wisconsin
Care Wisconsin is a non-profit managed care organization that matches frail seniors and people with physical and intellectual disabilities to the health care and long-term care supports and services they need. To learn more about Care Wisconsin,
About Dean Health Plan
With access to more than 4,000 practitioners at close to 200 primary care sites and 28 hospitals, Dean Health Plan is one of the largest and most diversified HMOs in the Midwest. It maintains a position of leadership in insurance services through an integrated delivery network of physician practices, hospitals, pharmacies, post-acute services as well as a wholly-owned pharmacy benefits management company that are part of SSM Health, a St. Louis-based integrated health system. Additional information can be found at
About Health Alliance Medical Plans
Health Alliance Medical Plans is a leading provider-driven health plan serving Illinois, Iowa, Indiana, Ohio and Washington. In 2017, Health Alliance was awarded by J.D. Power for highest member satisfaction among commercial health plans in the Illinois and Indiana Region. For more information, visit
HealthPartners is the largest consumer-governed, non-profit health care organization in the nation with a mission to improve health and well-being in partnership with members, patients and the community. For more information, visit
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America's leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 11.8 million members in eight states and the District of Columbia. For more information, go to
About Leon Medical Centers Health Plans
More than 2,300 dedicated health care professionals serve more than 40,000 Medicare recipients through Leon Medical Centers. Leon Medical Centers Health Plans, Inc. is a Cigna-HealthSpring company with a Medicare Advantage contract. Members have access to seven state-of-the-art centers, four healthy living centers throughout Miami-Dade as well as Leon Hospital Service Centers locations in the most prominent South Florida hospitals. For more information, visit
About Tufts Health Plan
Tufts Health Plan is nationally recognized for its commitment to providing innovative, high-quality health care coverage. Staying true to our mission of improving the health and wellness of the diverse communities we serve, we touch the lives of more than 1.1 million members in Massachusetts, Rhode Island and New Hampshire through employer-sponsored plans, Medicare, Medicaid and Marketplace plans, offering health insurance coverage across the life span regardless of age or circumstance. To learn more, visit tuftshealthplan.com/connections.