San Francisco Health Plan Receives 4-Star NCQA Medi-Cal Health Plan Rating

SAN FRANCISCO, Oct. 22, 2019 /PRNewswire/ -- San Francisco Health Plan (SFHP), a community health plan serving over 150,000 San Francisco residents, announced today that the National Committee for Quality Assurance (NCQA) has awarded the organization a 4-Star Commendable Accreditation for its Medicaid (Medi-Cal) HMO line of business. This official designation recognizes SFHP's commitment to quality of care for its members.

SFHP ratings improved to 4-Star Commendable from Accredited due to the efforts of the SFHP Health Outcomes Improvement and Provider Network Operations team in partnership with our Provider Networks to increase access to care, utilization of services and overall member satisfaction. Less than 25% of Medicaid health plans nationally have achieved this level of recognition. Our improvement strategies were developed based upon provider and member feedback through surveys, focus groups and one-on-one provider communications. The interventions included the launch of several innovative programs to improve access and member satisfaction including Health Care Education and Incentives, Teladoc® telemedicine services, member portal online services and social media educational initiatives.  The health plan rating is based on the combined scores from Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Health Plans Study (CAHPS) survey, and NCQA Accreditation standards.

"SFHP is now a part of an elite group of Medi-Cal health plans in California and the only one in San Francisco, that have earned this 4-Star Commendable rating distinction," said John F. Grgurina, Jr., CEO of San Francisco Health Plan. "This achievement is especially gratifying since it acknowledges both the quality of care that SFHP provides its members working alongside our network of providers, as well as the hard work of our dedicated staff to attain this level of national recognition."

Jim Glauber, MD, MPH, SFHP's Chief Medical Officer stated, "Our goal is to continuously improve our members' quality and experience of care, through innovative and collaborative health care strategies. SFHP has been highly responsive to its membership needs by launching transformative programs to provide the best possible health outcomes for our members.  Receiving this national recognition further supports our commitment to the highest quality standards and managed care practices."

Launched in 1997, SFHP provides health care to over 150,000 members. Combined with Healthy San Francisco, the City's non-insurance health care access program, SFHP provides services to over 150,000 residents, or over 17% of the City's population, which is one in six San Francisco residents.

Furthermore John F. Grgurina, Jr., CEO, added, "This award reinforces the strategic direction set forth by our Governing Board and the commitment to our mission to improve health outcomes of the diverse San Francisco communities through successful partnerships.  We look forward to continuing to serve our members with the best health and wellness care."

About San Francisco Health Plan
San Francisco Health Plan, a licensed community health plan providing affordable health coverage to over 150,000 low and moderate-income families residing in San Francisco. SFHP is designed for and by the residents it serves—many of whom would not be able to otherwise obtain health care for themselves or their families. Through SFHP, members have access to a full spectrum of medical services including preventive care, hospitalization, prescription drugs, family planning, and substance abuse programs. SFHP's mission is to improve health outcomes of the diverse San Francisco communities through successful partnerships. San Francisco Health Plan is also the third party administrator for the nationally recognized Healthy San Francisco program. For more information on SFHP, visit www.sfhp.org,

About NCQA
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.

SOURCE San Francisco Health Plan

Related Links

http://www.sfhp.org