SAN JUAN, Puerto Rico, Oct. 10, 2019 /PRNewswire/ -- Triple-S Management Corporation (NYSE: GTS) ("Triple-S" or the "Company"), a leading managed care company in Puerto Rico, announced today that the 2020 Care Coordination Medicare Advantage HMO contract (H5774) of its subsidiary, Triple-S Advantage, Inc., will remain among Medicare Advantage plans with at least a 4-star rating (out of a maximum possible rating of 5 stars, as determined by the Centers for Medicare and Medicaid Services) for a fourth consecutive year.
"Only 1 in 3 Medicare Advantage plans are 4 stars or higher in the U.S.,"1 said Madeline Hernández-Urquiza, President of Triple-S Advantage, Inc. "This is the fourth straight year we have earned a 4-star rating or higher. While we are pleased with this achievement, we continue strengthening our efforts to help our members live healthier and have an excellent overall experience with Triple-S, particularly when it comes to service, treatment adherence and engagement in our clinical programs."
Triple-S Advantage received a 4-star rating in its HMO contract and 4.5 stars in its Part D (Pharmacy) offering. The new ratings reflect a half-star reduction from current ratings of 4.5 stars (HMO) and 5 stars (Part D), respectively, and will apply in payment year 2021.
"As standards for Medicare Advantage become more rigorous, maintaining a 4-star rating or higher becomes an even more vital objective to achieve," added Ms. Hernández-Urquiza. "While the bar in star rating continues to be raised, these more stringent standards ultimately translate into better health services for our members."
The CMS Star Rating System reflects the quality of care that the member receives, as well as their satisfaction with their plan, and considers measures such as preventive tests, the management of chronic conditions such as diabetes and hypertension, the prevention of falls and hospital readmissions and compliance with medication therapies, among others. Each year, CMS collects this data and, based on it, issues a rating of one to five stars.
About Triple-S Management Corporation
Triple-S Management Corporation is an independent licensee of the Blue Cross Blue Shield Association. It is one of the leading players in the managed care industry in Puerto Rico. 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, and Costa Rica. With almost 60 years of experience in the industry, Triple-S Management offers a broad portfolio of managed care and related products in the Commercial, Medicare Advantage, and Medicaid markets under the Blue Cross Blue Shield marks. It also provides non-Blue Cross Blue Shield branded life and property and casualty insurance in Puerto Rico. Triple-S Advantage, Inc. is a Health Maintenance Organization (HMO) with a Medicare contract and a contract with the Puerto Rico Medicaid Program. Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next. The achieved rating applies to the 2020 contract year. For more information about Triple-S Management, visit www.triplesmanagement.com or contact [email protected].
Forward-Looking Statements
This document informs the market of our new CMS ratings but does not in any other respect update our disclosures. 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
- 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
- A downgrade in the Government of Puerto Rico's debt
- Litigation or legislation targeted at managed care, life insurance or property and casualty insurance companies
- Ability to contract with providers 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.
1https://www.cms.gov/Medicare/Prescription-DrugCoverage/PrescriptionDrugCovGenIn/PerformanceData.html
AT THE COMPANY: |
INVESTOR RELATIONS: |
Juan José Román-Jiménez |
Mr. Garrett Edson |
EVP and Chief Financial Officer |
ICR |
(787) 749-4949 |
(787) 792-6488 |
SOURCE Triple-S Management Corporation
Related Links
http://www.triplesmanagement.com
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