Healthfirst Managed Medicaid and Health and Recovery (HARP) Plans Rated Top Tier for Quality

Jun 07, 2024

Downstate New York’s Largest Medicaid Managed Care Plan Has Earned Top Tier Ranking Four out of the Last Five Years

Healthfirst PHSP, Inc., the largest not-for-profit Managed Medicaid Care Plan in New York, has again earned a top-tier ranking in overall quality and member satisfaction as measured by the New York State Department of Health (NYSDOH) 2022 Medicaid Quality Incentive Program. Among New York State’s twelve Managed Medicaid plans, Healthfirst is one of only two plans to achieve a top-tier ranking and is the only plan in its service area to do so. The ratings are based on the plan’s performance across preventive care, behavioral health, and medication measures, as well as member satisfaction with plan quality, getting needed care, and customer service. Healthfirst earned a number one ranking for its performance on Healthcare Effectiveness Data and Information Set (HEDIS®) measures, which reflect the quality of care provided across the delivery system.

Healthfirst also earned the highest score in the 2022 NYSDOH Health and Recovery Plan (HARP) Quality Incentive Program. HARP is designed to manage physical health, mental health, and addiction services in an integrated way for adults with significant behavioral health needs.

“Providing New Yorkers with affordable, equitable, and high-quality healthcare has been Healthfirst’s mission for, more than 30 years, and our strong quality scores and top-tier ranking demonstrate that we and our committed healthcare provider partners are delivering on that promise,” said Pat Wang, President and CEO, Healthfirst. “Today, we serve close to two million members, including one-third of downstate New York’s Medicaid population. These ratings are powerful evidence of our belief that all New Yorkers deserve the highest quality care regardless of income. Our commitment to help our community recertify their Medicaid coverage has also kept more people insured, a threshold requirement to have access to the care they need.”

About the NYS Medicaid Quality Incentive Program:

The New York State Medicaid Quality Incentive Program uses multiple data sources to determine results, including the following:

  • 2022 Quality Assurance Reporting Requirements (QARR) (measurement year 2022);
  • The most recent Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey for Medicaid, which was administered in the fall of 2022 with results released in reports dated May 2023; and
  • Regulatory compliance information from 2021 and 2022.

A plan’s score and ranking in the program indicates the quality of care provided to the plan’s members relative to all plans in the Medicaid Managed Care market.

About the NYS HARP Quality Incentive Program:

The New York State HARP Quality Incentive Program performance is based on data from the 2022 Quality Assurance Reporting Requirements (QARR). A plan’s score in the program indicates the quality of care provided to the plan’s members, particularly in behavioral health.