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- PPO and Pharmacy plan ratings also increase -
SAN JUAN, Puerto Rico, Oct. 8, 2021 /PRNewswire/ -- Triple-S Management Corporation (NYSE: GTS), a leading healthcare services company in Puerto Rico, today announced that for 2022 its Triple-S Advantage coordinated care contract (HMO H5774) received a quality rating of 4.5 stars out of a maximum possible rating of 5 stars by the Centers for Medicare & Medicaid Services (CMS), the regulatory agency for Medicare Advantage plans.
In addition, its preferred provider contract (PPO H4005) increased its quality rating to 4 stars, while Triple-S's Part D (Pharmacy) plan for both the HMO and PPO contracts received a maximum 5-star rating.
Through these contracts and its close collaboration with its physician and business partners, Triple-S Management offers top-quality services to the more than 136,000 Medicare Advantage members they serve.
"This recognition reflects our commitment to providing excellent service to our members and other stakeholders, and the quality of our clinical programs that facilitate continuity of holistic care," said Roberto Garcia-Rodriguez, President and Chief Executive Officer. "Promoting longer, healthier lives is our guiding principle in all clinical and service initiatives at Triple-S Advantage. We constantly seek innovative benefits and services that support better health outcomes, including attention to the social factors impacting health. We also seek to improve members' experience with their plans and the providers that serve them. That approach has enabled us to maintain our position of excellence."
The upgraded ratings are additional validation of the Company's efforts throughout the pandemic. Triple-S Advantage redoubled its efforts to provide and facilitate access to health services and address social factors during one of the country's most severe public health crises.
"Not only did we meet CMS's strict requirements, but we expanded telemedicine services, facilitated food delivery for close to 44,000 of our most vulnerable members and covered the cost of prepared food delivery for others. We also made it easier for our members to manage and receive their prescriptions and OTCs," added Mr. Garcia-Rodriguez.
The CMS Star Rating System reflects the quality of care a member receives, as well as the level of satisfaction with their plan. It considers measures such as preventive screenings, management of chronic conditions, such as diabetes and hypertension; prevention of falls; hospital readmissions; and the level of member adherence to drug therapies, among others. Each year, CMS compiles this data and based on it issues a rating from one to five stars, with 1 star being poor performance and 5 stars representing exceptional service.
About Triple-S Management Corporation
Triple-S Management, a health services company, serves more than 1 million customers in Puerto Rico, which represents nearly one-third of the island's population. With over 60 years of experience, it is the premier insurance and managed care brand, with the largest customer base and broadest provider networks on the island. Triple-S Management has the exclusive right to use the Blue Cross Blue Shield name and mark throughout Puerto Rico, the U.S. Virgin Islands, Costa Rica, the British Virgin Islands and Anguilla, and offers a broad portfolio of managed care and related products in the commercial, Medicare Advantage and Medicaid segments. Triple-S Management is also a well-known brand in the life insurance and property and casualty insurance segments in Puerto Rico, with strong customer relationships and a significant market share. For more information about Triple-S Management, visit www.triplesmanagement.com or contact email@example.com.
This document contains forward-looking statements, as defined in the Private Securities Litigation Reform Act of 1995. Forward-looking statements include information about possible or assumed future sales, results of operations, developments, regulatory approvals or other circumstances. Sentences that include "believe", "expect", "plan", "intend", "estimate", "anticipate", "project", "may", "will", "shall", "should" and similar expressions, whether in the positive or negative, are intended to identify forward-looking statements.
All forward-looking statements in this news release reflect management's current views about future events and are based on assumptions and subject to risks and uncertainties. Consequently, actual results may differ materially from those expressed here as a result of various factors, including all the risks discussed and identified in public filings with the U.S. Securities and Exchange Commission (SEC).
In addition, the Company operates in a highly competitive, constantly changing environment, influenced by very large organizations that have resulted from business combinations, aggressive marketing and pricing practices of competitors, and regulatory oversight. The following factors, if markedly different from the Company's planning assumptions (either individually or in combination), could cause Triple-S Management's results to differ materially from those expressed in any forward-looking statements shared here:
Trends in health care costs and utilization rates
Ability to secure sufficient premium rate increases
Competitor pricing below market trends of increasing costs
Re-estimates of policy and contract liabilities and reserves
Changes in government laws and regulations of managed care, life insurance or property and casualty insurance
Significant acquisitions or divestitures by major competitors
Introduction and use of new prescription drugs and technologies
A downgrade in the Company's financial strength ratings
Litigation or legislation targeted at managed care, life insurance or property and casualty insurance companies
Ability to contract with providers and government agencies consistent with past practice
Ability to successfully implement the Company's disease management, utilization management and Star ratings programs
Ability to maintain Federal Employees, Medicare and Medicaid contracts
Volatility in the securities markets and investment losses and defaults
General economic downturns, major disasters and epidemics
This list is not exhaustive. Management believes the forward-looking statements in this release are reasonable. However, there is no assurance that the actions, events or results anticipated by the forward-looking statements will occur or, if any of them do, what impact they will have on the Company's results of operations or financial condition. In view of these uncertainties, investors should not place undue reliance on any forward-looking statements, which are based on current expectations. In addition, forward-looking statements are based on information available the day they are made, and (other than as required by applicable law, including the securities laws of the United States) the Company does not intend to update or revise any of them in light of new information or future events.
Readers are advised to carefully review and consider the various disclosures in the Company's SEC reports.
FOR FURTHER INFORMATION:
AT THE COMPANY:
Victor J. Haddock-Morales
Mr. Garrett Edson
EVP and Chief Financial Officer
SOURCE Triple-S Management Corporation