California Medicare Advantage plan earns high marks for diabetes care, prescription drug coverage, customer service

ORANGE, Calif., Oct. 16, 2017 – Alignment Healthcare, an Orange, California-based health care company offering Medicare Advantage (MA) insurance coverage for seniors, announced today that its Alignment Health Plan received an overall 4.5-star rating out of a possible 5 stars from the Centers for Medicare & Medicaid Services (CMS).

Up from the previous year’s 3-star rating, Alignment Health Plan is one of only five MA plans in California to earn the 4.5-star rating through the nationally recognized quality rating system for Medicare Part C and Part D plans.

“We are delighted to receive this high rating because it validates our belief that putting people, not payments, at the center of everything we do, can really change the way care is delivered,” said John Kao, CEO and president of Alignment Healthcare. “Our approach is based on alleviating some of the biggest pain points for seniors: access and coordination of care. By connecting our members’ physicians, hospitals, pharmacies, and other care providers, we can ensure that every member gets the care he or she needs in a coordinated manner and that information is shared among those involved in the care delivery.”

Alignment Health Plan received a 5-star rating for its Part D prescription drug plan, ranking in the 97th percentile among all rated plans. Alignment also achieved 5-star ratings across the board for all diabetes-specific CMS criteria, and in key customer service areas for drug plan and health plan performance:

  • Diabetes Care – Eye Exam
  • Diabetes Care – Kidney Disease Monitoring
  • Diabetes Care – Blood Sugar Controlled
  • Care for Older Adults – Medication Review
  • Care for Older Adults – Pain Assessment
  • Osteoporosis – Management in Women Who Had a Fracture
  • Health Plan Customer Service Domain
  • Drug Plan Customer Service Domain

Chronic disease management of conditions, such as diabetes, is a particular area where Alignment Healthcare excels. Alignment provides remote monitoring of chronically ill patients, analyzing incoming clinical data through the company’s “command center” to enable continuous, real-time tracking of their health status so that medical interventions can be timely and appropriate.

“We have developed technology that analyzes data to better predict patient outcomes and get ahead of patients’ needs,” said John Kim, MD, chief medical officer of Alignment Health Plan. “We’ve armed our clinical teams with the tools they need to address potential patient issues before they happen.”

That responsiveness and early intervention has led to improved clinical outcomes: In California, patients enrolled in Alignment Healthcare’s home monitoring program experienced 38 percent fewer emergency room visits than before they enrolled in the program.

The Centers for Medicare & Medicaid Services created the Medicare star quality rating system to provide beneficiaries with a way to assess Medicare Advantage (Part C) and prescription drug (Part D) plans based on quality of care and service delivery. As part of its annual Star ratings for 2018, CMS calculated Star ratings from 1 to 5 (with 5 being the best) based on quality and performance for Medicare health and drug plans to help beneficiaries, their families and caregivers compare plans. Ratings are given for quality measures across several categories including keeping members healthy, managing chronic conditions, member satisfaction, customer service and pharmacy services.

About Alignment Healthcare

Alignment Healthcare is redefining the business of health care by shifting the focus from payments to people. We’ve created a new model for health care delivery that cuts costs and improves lives by unraveling the inefficiencies of the current system to drive patients, providers and payers toward a common goal of wellness. Harnessing best practices from Medicare Advantage, our innovative data-management technology allows us to commit to caring for seniors and those who need it most: the chronically ill and frail. With offices and care centers across the country, Alignment Healthcare provides partners and patients with customized care and service where they need it and when they need it, including clinical coordination, risk management and technology facilitation. Alignment Healthcare offers health plan options to California residents through Alignment Health Plan, and partners with select health plans in North Carolina and Florida to help deliver better benefits at lower costs. For more information, please visit

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Maggie Habib
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