Award-Winning Health Programs Are Ultimately Good for Our Members

By Laura Hungiville

The results are in! On May 16, WellCare’s Prescription Drug Plan (PDP) was honored with the 2018 Pharmacy Quality Alliance (PQA) Quality Improvement award, which recognizes the plan with the greatest combined improvement in Star Ratings from 2018 to 2019 on PQA medication measures used within the Centers for Medicare & Medicaid Services (CMS) Medicare Part D Star Ratings program.  PQA-endorsed measures include medication adherence related to diabetes, hypertension and cholesterol.

While we’re thrilled to receive this important industry recognition, why is this important news for our members?

Each year, CMS releases its Medicare Star Ratings to rank the performance and quality of Medicare Advantage and Medicare PDPs to help beneficiaries and their families compare plans. Star Ratings are calculated using a scale of 1.0 to 5.0 (with 5.0 being the highest) and may change from year to year. PQA is a multi-stakeholder organization that helps promote performance measures related to medication use, many of which have been used by CMS to evaluate Medicare Part D plans.

Improving Medication Adherence One Member at a Time

Sticking to a medication routine – also known as medication adherence – means taking medications as prescribed. The right doses, at the right time, in the right way and frequency, are critical to good health.

This was no easy feat. We work closely with our key pharmacy stakeholders –members, providers and pharmacies – to identify solutions to improve medication adherence. As a result, we directly engage members with refill reminders before their medications run out and alert them via phone calls, interactive voice responses and letters when they miss refills. Members are also encouraged to talk to their healthcare providers about changing their medications to more convenient 90-day refills.

We also partnered with providers and pharmacies, alerting providers when their patients were not taking needed medications, while working with frontline pharmacists to help directly engage members and discuss any medication-related issues.

But we’re not resting on our laurels. We are committed to continuing this momentum and will focus on providing a quality PDP for our members. At the end of the day, our goal is to provide quality care to our members to help them and their families live better, healthier lives.

Hungiville_LauraLaura Hungiville is WellCare’s Senior Vice President and Chief Pharmacy Officer.

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