Quality
Martin’s Point Health Care (Martin’s Point) strives to provide health plans that are among the best in the nation.
We are committed to supporting the delivery of care and service that meets the highest standards for safety, effectiveness, and customer experience.
Health Plan Quality Program Summary
At Martin’s Point Health Care, the Health Plan Quality Department is committed to delivering exceptional health outcomes and member experiences. The department focuses on continuous improvement in healthcare quality, aligning with nationally recognized standards and performance measures to ensure excellence.
Key areas of focus include:
HEDIS (Healthcare Effectiveness Data and Information Set)
The department tracks and reports HEDIS measures, a widely used set of performance metrics developed by NCQA. These measures evaluate care quality in areas such as preventive services, chronic disease management, and medication adherence. Martin’s Point utilizes HEDIS data to identify opportunities for improvement and collaborate with providers to enhance patient outcomes.
Learn more about our HEDIS program here:
& Information Set (HEDIS)
CAHPS (Consumer Assessment of Health Care Providers and Systems)
Martin’s Point uses the CAHPS® surveys to ask members about their experiences with the quality of care and customer service that we provide, i.e., health plans, prescription plans, and care providers.
The surveys focus on factors that members say are important to them, such as getting care easily and quickly, the quality of care provided by their primary care doctor or specialist, the coordination of their health care across the health care system, and overall service quality. When surveyed, our Martin’s Point health plan members continually exceed top benchmarks for member satisfaction.
CAHPS Survey
Martin’s Point uses the CAHPS® surveys to ask members about their experiences with the quality of care and customer service that we provide, i.e., health plans, prescription plans, and care providers.
The surveys focus on factors that members say are important to them, such as getting care easily and quickly, the quality of care provided by their primary care doctor or specialist, the coordination of their health care across the health care system, and overall service quality. When surveyed, our Martin’s Point health plan members continually exceed top benchmarks for member satisfaction.
Generations Advantage
Medicare Star Ratings
Martin’s Point strives for high performance in the CMS Star Ratings program, which evaluates Medicare Advantage plans across multiple domains, including clinical quality, member satisfaction, and operational performance. The department works closely with providers to implement strategies that support high-quality care and optimize Star Ratings.
For 2024, our Generations Advantage HMO plans earned 4.0 out of 5 stars: Prime | Alliance | Value Plus
Our LPPO plans earned 3.0 out of 5 stars: Select | Access
US Family Health Plan
NCQA Health Plan Ratings
Martin’s Point consistently pursues excellence in NCQA Health Plan Ratings, a benchmark of plan quality and effectiveness.
Achieving strong ratings reflects the organization’s dedication to providing superior care and services.
For 2024, the US Family Health Plan earned 4.0 out of 5 stars for quality performance—this includes earning a rating of 5 out of 5 for Patient Experience measures.
NCQA Accreditation for USFHP
Martin’s Point is proud to maintain NCQA accreditation, demonstrating its adherence to the highest standards in health plan operations, member service, and clinical quality. This accreditation underscores the organization’s commitment to accountability and quality improvement.
NCQA standards provide a roadmap to improvement in multiple areas to keep members healthy:
- Quality Management and Improvement
- Population Health Management
- Network Management
- Utilization Management
- Credentialing and Recredentialing
- Members’ Rights and Responsibilities
- Member Connections
The National Committee on Quality Assurance (NCQA) has awarded the US Family Health Plan the accreditation status of Accredited for 2022-2025.
Martin's Point Health Care Clinical Guidelines
Martin’s Point Health Care adopts guidelines for the prevention and treatment of illness and disease from nationally recognized government organizations and medical specialty societies. MPHC reviews and revises these guidelines annually or more frequently if needed.