EmblemHealth Maintains 4-Star Medicare Rating, Highlighting Sustained Quality Performance
NEW YORK, Oct. 14, 2026 (GLOBE NEWSWIRE) -- EmblemHealth, one of the nation’s largest not-for-profit health insurers, has maintained its 4-star rating from the Centers for Medicare & Medicaid Services (CMS) for the company's largest Medicare Advantage contract (H3330).
EmblemHealth's 4-star rating comes as fewer Medicare Advantage plans offering prescription drug coverage (MA-PD plans) nationwide earned 4 stars or higher, with approximately 37% reaching that threshold for 2027, down from 44% the previous year as reported by CMS.
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.
While sustaining its overall 4-star rating, EmblemHealth also demonstrated gains across key quality measures, with 10 of 36 individual measures earning a higher Star Ratings compared to last year, including:
- Diabetes Care: Earned a 5-star rating for controlled blood sugar, up from 4 stars.
- Cardiovascular Health: Medication adherence for cholesterol management and statin therapy for members with cardiovascular disease each increased to 4 stars.
- Member Services: Earned 5 stars in measures evaluating complaints about the health plan and prescription drug plan, up from 4 stars.
"Achieving a 4-star rating is significant but maintaining it starts with listening to the members we serve and taking action on what we hear," said SVP, Strategy, and Chief Health Equity Officer Abdou Bah. "At EmblemHealth, that commitment extends beyond any single quality measure. Whether it’s a diabetes wellness screening at our Neighborhood Care centers or coordinating care with our physician group AdvantageCare Physicians, every interaction is a moment to better serve the health of our members and communities.”
EmblemHealth’s sustained 4-star Medicare rating builds on its history of recognition for healthcare quality, including the Pharmacy Quality Alliance (PQA) Quality Improvement Award, and Health Equity Accreditation from the National Committee for Quality Assurance (NCQA). Beyond the measures evaluated by CMS, EmblemHealth also supports community-based programs addressing diabetes and food insecurity for members and nonmembers.
For more information on EmblemHealth plans or to speak to a specialist for help finding the right plan, call 888-225-6133 (TTY: 711) from 8 a.m. to 8 p.m., seven days a week.
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 over a dozen EmblemHealth Neighborhood Care locations, members and nonmembers alike 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