NEWTOWN SQUARE, Pa.–(BUSINESS WIRE)–AmeriHealth Caritas Family of Companies, a national leader in Medicaid managed care and other health care solutions for those who need it most, announced that AmeriHealth Caritas Pennsylvania and AmeriHealth Caritas Pennsylvania Community HealthChoices are two of the nation’s top-rated health insurance plans, both earning 4.5 out of 5 ratings in the 2022 National Committee for Quality Assurance (NCQA) Medicaid Health Plan Evaluations. AmeriHealth Caritas Pennsylvania and AmeriHealth Caritas Pennsylvania Community HealthChoices are the only two Medicaid plans in Pennsylvania — and two of only 13 in the nation — to score 4.5 or higher.
AmeriHealth Caritas Pennsylvania and AmeriHealth Caritas Pennsylvania Community HealthChoices earned their rating of 4.5 out of 5 based on strong results from the Healthcare Efficiency Data and Information Set (HEDIS®), the measurement tool used by health plans nationwide to assess their performance in terms of quality and customer service, as well as the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey, which measures member satisfaction with regarding their overall health care experience.
AmeriHealth Caritas Pennsylvania serves enrollees in Pennsylvania’s HealthChoices managed care program for most Pennsylvania Medical Assistance (Medicaid) enrollees. AmeriHealth Caritas Pennsylvania Community HealthChoices serves Pennsylvanians ages 21 and older who are eligible for Medicaid and Medicare or who are eligible to receive long-term services and supports because they require the level of care provided by a nursing facility . Both plans serve the same 62 counties in Pennsylvania.
AmeriHealth Caritas Family of Companies has served the HealthChoices and Community HealthChoices programs since their inception in 1996 and 2017, respectively.
“This achievement is testament to the effectiveness of our model of care and services in supporting Pennsylvanians who need it most,” said AmeriHealth Caritas Family of Companies Executive Vice President and Chief Medical Officer Dr. Karen Amstutz. . “Since our first day serving Community HealthChoices participants nearly five years ago, we have been committed to providing them with the same quality of service and access to care enjoyed by our other members nationwide. It is a privilege to partner with the state and help maximize the independence and quality of life for these Pennsylvanians.
Supporting Pennsylvania’s Most Vulnerable with Access to Quality Health Care
Community HealthChoices participants are particularly vulnerable due to their age and/or physical challenges. In an effort to help them live in their communities rather than in a long-term care facility, AmeriHealth Caritas Pennsylvania Community HealthChoices coordinates participant care and, for those eligible, home and community services, such as of everyday life, assistive technology, vehicle modifications, and much more.
The AmeriHealth Caritas family of companies is proud to work with the Pennsylvania Office of Long-Term Living, providers and community organizations to help manage care and services for more than 175,000 Community HealthChoices participants nationwide. ‘State.
Continue to provide Medicaid to the people of Pennsylvania
AmeriHealth Caritas Pennsylvania earned a 4.5 out of 5 rating for the fourth time in five rating cycles, matching its performance in the NCQA’s 2017, 2019, and 2021 Medicaid Health Plan ratings. not published ratings in 2020.
AmeriHealth Caritas Pennsylvania provides Pennsylvania Medicaid enrollees with innovative programs that focus on the social determinants of health, such as food security, education, and employment, as well as addressing health disparities. His efforts to foster culturally competent care have earned the plan the NCQA Multicultural Health Care Award six times.
With the launch of the new Pennsylvania HealthChoices contract on September 1, AmeriHealth Caritas Pennsylvania has expanded to the southwest area of the program. Between AmeriHealth Caritas Pennsylvania and its Southeastern Pennsylvania Medicaid plan, the AmeriHealth Caritas Family of Companies health plans now serve approximately 1 million HealthChoices enrollees in all 67 counties.
NCQA is a private, nonprofit organization dedicated to improving the quality of health care. The NCQA accredits and certifies a wide range of healthcare organizations and recognizes clinicians in key clinical areas. The NCQA’s HEDIS® is the most widely used performance measurement tool in healthcare. The NCQA website (www.ncqa.org) contains information to help consumers, employers and others make informed health care choices.
About AmeriHealth Caritas
AmeriHealth Caritas is a national leader in healthcare solutions for those who need it most. Operating in 12 states and the District of Columbia, AmeriHealth Caritas serves approximately 5 million Medicaid, Medicare, Children’s Health Insurance Program (CHIP) and Health Insurance Marketplace® members through its integrated managed care products, benefits management pharmaceuticals and specialty pharmaceutical services, and behavioral health services. Based in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with nearly 40 years of experience serving low-income and chronically ill populations. For more information, visit www.amerihealthcaritas.com.
HEDIS is a registered trademark of NCQA.
CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
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