AmeriHealth Caritas Pennsylvania, AmeriHealth Caritas Pennsylvania Community HealthChoices Named Among Nation’s Highest-Rated Health Insurance Plans

Medicaid Health Plans Two of Only 13 Medicaid Plans Nationwide to Receive 4.5 out of 5 Rating or Higher

AmeriHealth Caritas Family of Companies, a national leader in Medicaid managed care and other health care solutions for those most in need, announced that AmeriHealth Caritas Pennsylvania and AmeriHealth Caritas Pennsylvania Community HealthChoices are two of the highest-rated health insurance plans in the nation, having both earned 4.5 out of 5 ratings in the National Committee for Quality Assurance’s (NCQA) Medicaid Health Plan Ratings 2022. 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 earn a rating of 4.5 or higher.

AmeriHealth Caritas Pennsylvania and AmeriHealth Caritas Pennsylvania Community HealthChoices earned their 4.5 out of 5 ratings based on strong results from the Healthcare Effectiveness Data and Information Set (HEDIS®), the measurement tool used by the nation’s health plans to evaluate their performance in terms of clinical quality and customer service, as well as the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey, which measures members’ satisfaction with 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 qualify to receive long-term services and supports because they need the level of care provided by a nursing facility. Both plans serve the same 62 Pennsylvania counties.

AmeriHealth Caritas Family of Companies has served the HealthChoices and Community HealthChoices programs since their inceptions in 1996 and 2017, respectively.

“This accomplishment is a testament to the effectiveness of our model of care and service in supporting Pennsylvanians most in need,” said AmeriHealth Caritas Family of Companies Executive Vice President and Chief Medical Officer Dr. Karen Amstutz. “From 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’s a privilege to partner with the state and help maximize these Pennsylvanians’ independence and quality of life.”

Supporting Pennsylvania’s Most Vulnerable with Access to Quality Health Care

Community HealthChoices participants are particularly vulnerable given their age and/or physical challenges. In an effort to help them live in their communities versus a long-term care facility, AmeriHealth Caritas Pennsylvania Community HealthChoices coordinates participants’ care and, for those eligible, home and community-based services, such as daily living services, assistive technology, vehicle modifications, and much more.

AmeriHealth Caritas Family of Companies is proud to work with Pennsylvania’s Office of Long-Term Living, providers, and community organizations to help manage care and services for more than 175,000 Community HealthChoices participants statewide.

Continuing to Deliver for Pennsylvania’s Medicaid Population

AmeriHealth Caritas Pennsylvania earned a rating of 4.5 out of 5 for the fourth time in five ratings cycles, matching its performance in NCQA’s Medicaid Health Plan Ratings 2017, 2019, and 2021. NCQA did not release ratings in 2020.

AmeriHealth Caritas Pennsylvania provides Pennsylvania Medicaid enrollees with innovative programs focused on the social determinants of health, such as food security, education, and employment, as well as addressing health disparities. Its efforts to foster culturally competent care have earned the plan the NCQA’s Multicultural Health Care Distinction six times.

With the launch of Pennsylvania’s new HealthChoices contract on Sept. 1, AmeriHealth Caritas Pennsylvania expanded into the program’s Southwest Zone. Between AmeriHealth Caritas Pennsylvania and its southeastern Pennsylvania Medicaid plan, 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 health care quality. NCQA Accredits and Certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS® is the most widely used performance measurement tool in health care. NCQA's website (www.ncqa.org) contains information to help consumers, employers and others make informed health care choices.

About AmeriHealth Caritas

AmeriHealth Caritas is one of the nation’s leaders in health care solutions for those most in need. 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, pharmaceutical benefit management and specialty pharmacy services, and behavioral health services. Headquartered in Newtown Square, Pa., 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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