EmblemHealth Achieves 4-Star Medicare Rating, Highlighting Sustained Quality Improvements
Defying national trends in downward Medicare Advantage ratings for not-for-profit health plans, EmblemHealth increased its Medicare Star rating for the second consecutive year.
NEW YORK, Oct. 14, 2025 (GLOBE NEWSWIRE) -- EmblemHealth, one of the nation’s largest not-for-profit health insurers, has been awarded a 4-Star rating from the Centers for Medicare & Medicaid Services (CMS) across multiple Medicare HMO plans. This marks the second consecutive year of upward momentum and underscores EmblemHealth’s commitment to high-quality care and population health.
“Earning a 4-Star Medicare rating reflects that investing in prevention, care coordination, and community-focused programming produces measurable results for our members,” said Chief Health Equity Officer and SVP Medical Management Abdou Bah. “I’m especially proud that we’ve been able to move the needle on quality initiatives that drive meaningful adoption of life-saving programs for our most vulnerable members.”
The CMS Star ratings evaluate performance in preventive care, chronic condition management, medication adherence, customer service, and member experience. Health plans that earn 4 or more stars demonstrate strong performance in clinical and service measures. EmblemHealth received a 4-Star rating for multiple plan offerings including VIP Gold HMO, VIP Gold Plus HMO, VIP Premier HMO, VIP Rx Carve-Out HMO, and VIP Rx Saver HMO.
EmblemHealth’s 4-Star Medicare rating builds on recent recognitions for quality initiatives that improve health outcomes and increase access to health care including:
- Receiving the Pharmacy Quality Alliance (PQA) Quality Improvement Award, making it one of only eight organizations nationwide to be recognized. EmblemHealth improved more than 37% in quality measures across its Medicare product lines, demonstrating the strength and scalability of its pharmacy quality strategy.
- Earning Health Equity Accreditation from the National Committee for Quality Assurance (NCQA). This achievement made EmblemHealth the first insurer in New York state to earn accreditation across three product lines, including its commercial HMO and POS products, as well as its Medicaid HMO and Medicare HMO products.
EmblemHealth remains committed to building on these achievements by investing in provider networks, member engagement, and community-based programs to ensure that high-quality, accessible care can continue to reach its members and the communities we serve.
About EmblemHealth
EmblemHealth is one of the nation’s largest not-for-profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At more than a dozen EmblemHealth Neighborhood Care locations, members and nonmembers have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
Contact:
EmblemHealth Public Relations Office| Email: press@emblemhealth.com
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