Healthfirst Ranks #1 Overall in 2019 Medicaid Quality | Healthfirst

Healthfirst Ranks #1 Overall in 2019 Medicaid Quality

Sep 16, 2020

Earned Top Score in Clinical Quality and Achieved Strong Score on Member Satisfaction Measures


SEPTEMBER 16, 2020, New York, NY – Healthfirst’s Medicaid plan (Healthfirst PHSP, Inc.) ranked number one among all 15 New York State Medicaid plans in overall quality according to the New York State Department of Health’s 2019 Quality Incentive results. Healthfirst's Medicaid plan received a perfect score of 100% in clinical quality and received zero compliance deductions.

A key factor contributing to the top ranking was Healthfirst’s strong performance in access to care in the member satisfaction survey due to expansion of its provider network, improved appointment availability, and providing alternative options for care such as telehealth. The plan also outperformed other New York plans on quality measures for preventative and chronic care, including health screenings, labs, wellness visits, and immunizations in pediatric care.

“Providing our 1.5 million members with access to quality care is our top priority at Healthfirst, and it is gratifying to see this reflected in our quality score and number one ranking,” said Pat Wang, President and CEO of Healthfirst. “These accomplishments reflect the hard work across Healthfirst to fulfill our mission of getting quality care to those who need it most. This year, during the COVID-19 pandemic, we have experienced the highest growth in Medicaid members that we’ve ever seen, and today we insure one million Medicaid members, which represents nearly 25 percent of all Medicaid members in New York State.”

The New York State Quality Incentive program is based on reporting and measurement from activity in the prior calendar year. 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 and can help drive plan growth. As a provider-sponsored plan, Healthfirst reinvests the incentive dollars awarded through the program into continuous quality improvement efforts driven by our sponsor hospitals.

About the Medicaid Quality Incentive Scores:

The data used to determine the results included the following:

  • 2019 Quality Assurance Reporting Requirements (QARR) (measurement year 2018)
  • The most recent Medicaid CAHPS survey for children in Medicaid, which was administered in the fall of 2018 with results released in reports dated March 2019
  • PDI 90 Pediatric Quality Overall Composite and PQI 90 Prevention Quality Overall Composite using 2018 inpatient admissions
  • Regulatory compliance information from 2017 and 2018.