Medicare Star Rating

Our Rating

In 2012, Tufts Medicare Preferred HMO’s plans earned 4.5 stars out of 5. Our rating is based on our commitment to patient satisfaction and tracked by the Centers for Medicare & Medicaid Services.  The Plan Rating combines scores for the types of medical and/or prescription drug services each of our plans offer.

What is being measured?

Tufts Medicare HMO plans with only medical coverage

Overall Score

The overall score for quality of service covering 36 different topics in 5 categories for our Tufts Medicare HMO plans with only medical coverage.

5 starsStaying Healthy (screenings, tests, and vaccines)

Includes how often members got various screening tests, vaccines, and other check-ups that help them stay healthy.

4 starsManaging chronic (long-term) conditions

Includes how often members with different conditions got certain tests and treatments that help them manage their condition.

5 starsRatings of health plan responsiveness and care

Includes ratings of member satisfaction with the plan.

4 starsHealth plan member complaints and appeals

Includes how often members filed a complaint against the plan.

Tufts Medicare Preferred HMO plans that include prescription drug coverage

Overall Score

The overall score for quality of drug service covering 17 different topics in 4 categories for our Tufts Medicare Preferred HMO plans that include prescription drug coverage.

3 starsDrug plan customer service

Includes how well the drug plan handles calls and makes decisions about member appeals.

4 starsDrug plan member complaints and Medicare audit findings

Includes how often members filed a complaint about the drug plan and findings from Medicare’s audit of the plan

5 starsMember experience with drug plan

Includes member satisfaction information.

4 starsDrug pricing and patient safety

Includes how well the drug plan prices prescriptions and provides updated information on the Medicare website. Includes information on how often members with certain medical conditions get prescription drugs that are considered safer and clinically recommended for their condition.

For plans covering both medical & drug services, the overall score for quality of those services covers all of the 9 categories listed above.

Where does the information for the Overall Plan Rating come from?

For quality of health services, the information comes from sources that include:

• Member surveys done by Medicare
• Information from clinicians
• Information submitted by the plans
• Results from Medicare’s regular monitoring activities

For quality of drug services, the information comes from sources that include:

• Results from Medicare’s regular monitoring activities
• Reviews of billing and other information that plans submit to Medicare
• Member surveys done by Medicare

Why is the Overall Plan Rating important?

The Overall Plan Rating gives you a single summary score that makes it easy for you to compare plans based on quality and performance.