PHP earns Medicare Advantage 4.5 stars quality rating

Published: October 12, 2021

LANSING, Mich. — Physicians Health Plan (PHP), a subsidiary of Sparrow Health System, today announced that it has earned a Medicare Advantage quality rating of 4.5 stars (out of 5) from the U.S. Centers for Medicare & Medicaid Services (CMS). The rating means that members enrolled in PHP’s Medicare Advantage plans — PHP Advantage, Sparrow Advantage, Covenant Advantage, and U-M Health + St. Joe’s Advantage — have access to high quality Medicare Advantage plans offered by a locally owned and community-based health plan.

“As a local, personal and trusted health plan, PHP launched PHP Medicare to support better health outcomes for our region,” said Dennis Reese, president and chief executive officer of PHP. “We are proud that when members of our community research all-in-one Medicare Advantage plans with prescription drugs, they will find that PHP’s plans earn a CMS Star Rating of 4.5 for the 2022 plan year.”

PHP’s Medicare Advantage plans are offered in 15 Michigan counties: Bay, Calhoun, Clinton, Eaton, Gratiot, Ingham, Ionia, Jackson, Kalamazoo, Livingston, Montcalm, Saginaw, Shiawassee, Tuscola, and Washtenaw. Through its partnerships with health systems, PHP’s Medicare Advantage plans are known in local communities as PHP Advantage, Sparrow Advantage, Covenant Advantage, and U-M Health + St. Joe’s Advantage.

The CMS Star Rating system is designed to help consumers research and compare Medicare health and drug plans, with Star Ratings ranging from a low of 1 to a high of 5. CMS calculates overall star ratings through a comprehensive evaluation of multiple clinical, plan performance, and member satisfaction measures in five specific areas, each receiving their own Star Rating. Of the 30 clinical health measures PHP was evaluated, 26 achieved 4 or more stars. In addition, PHP Medicare’s customer service and member satisfaction ranked high with five stars for its health and drug plan customer service and member experience with the drug plan.

“PHP Medicare is set apart from other Medicare Advantage plans through our strong focus on physician engagement throughout our clinically integrated networks,” said PHP Chief Medical Officer Peter Graham, M.D. “Our comprehensive approach with our physician and health system partners allows us to directly address what’s most important to and will have the biggest benefit for our members’ health.”

In 2020, PHP launched PHP Medicare in 12 counties by partnering with Lansing-based Sparrow and Saginaw-based Covenant HealthCare. PHP Medicare expands in 2022 to serve 15 counties through a new partnership with Michigan Medicine and Saint Joseph Mercy Health System.

“Locally managed and nationally inspired, PHP earned its status as one of one of Michigan’s top health plans through an unrelenting commitment to local, personal and trusted care,” said PHP Vice President of Business Development and Medicare Scott Norman. “After four decades of serving our communities, we were well-positioned to extend our service through new Medicare Advantage plans. Our strong partnerships with local providers allow our members to continue their trusted relationship with their caregivers.”

With Medicare Advantage, members access all the benefits of Original Medicare, plus Part D drug coverage and additional benefits, such as dental, vision, and fitness programs.

CMS publishes its Medicare Advantage and Part D Star Ratings at Medicare.gov. Each year, Star Ratings are released to help Medicare beneficiaries make informed healthcare decisions while researching options during the Medicare open enrollment period, which this year runs Oct. 15 through Dec. 7.