Contract
H2450

Medica · 2027 Star Ratings

MEDICA INSURANCE COMPANY · 1876 Cost

Parent: Medica Holding Company

Summary ratings

Overall
3.0
2026: 3.5−0.5
Part C · health plan
3.0
2026: 3.5−0.5
Part D · drug plan
3.5
2026: 3.5±0

2027 footprint

Members, Sep 2026
115K
2027 plans
15
Open to all ($0 premium)
15 (12)
Counties
170
Special needs plans
None
Drug coverage
Yes
IAMNNDNESDWI

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines3.03.0±0
HD2Managing Chronic (Long Term) Conditions2.02.0±0
HD3Member Experience with Health Plan4.04.0±0
HD4Member Complaints and Changes in the Health Plan's Performance4.04.0±0
HD5Health Plan Customer Service5.03.0+2.0
DD1Drug Plan Customer ServiceNot enough data availableNot enough data available—
DD2Member Complaints and Changes in the Drug Plan's Performance4.04.0±0
DD3Member Experience with the Drug PlanNot enough data availableNot enough data available—
DD4Drug Safety and Accuracy of Drug Pricing4.04.0±0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening76%3.0−1
C02Colorectal Cancer Screening63%2.0new spec
C03Annual Flu Vaccine68%4.0±0
C04Improving or Maintaining Physical Health71%3.0±0
C05Improving or Maintaining Mental Health86%4.0±0
C06Monitoring Physical Activity40%1.0−1
C07Special Needs Plan (SNP) Care ManagementPlan not required to report measure—
C08Care for Older Adults – Medication ReviewPlan not required to report measure—
C09Care for Older Adults - Functional Status AssessmentPlan not required to report measure—
C10Osteoporosis Management in Women who had a Fracture27%1.0±0
C11Diabetes Care – Eye Exam67%2.0−1
C12Diabetes Care – Blood Sugar Controlled88%3.0±0
C13Kidney Health Evaluation for Patients with Diabetes30%1.0±0
C14Controlling High Blood Pressure76%2.0±0
C15Reducing the Risk of Falling47%1.0±0
C16Improving Bladder Control45%3.0+1
C17Plan All-Cause ReadmissionsNo data available—
C18Statin Therapy for Patients with Cardiovascular DiseasePlan not required to report measure—
C19Transitions of CarePlan not required to report measure—
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions53%1.0−1
C21Getting Needed Care813.0−1
C22Getting Appointments and Care Quickly833.0±0
C23Customer Service924.0−1
C24Rating of Health Care Quality874.0−1
C25Rating of Health Plan874.0±0
C26Care Coordination873.0−2
C27Complaints about the Health Plan0.065.0±0
C28Members Choosing to Leave the Plan2%5.0±0
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic1.0−2
C30Plan Makes Timely Decisions about Appeals98%4.0+1
C31Reviewing Appeals Decisions100%5.0+2
C32Call Center – Foreign Language Interpreter and TTY AvailabilityPlan not required to report measure—

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY AvailabilityPlan not required to report measure—
D02Complaints about the Drug Plan0.065.0±0
D03Members Choosing to Leave the Plan2%5.0±0
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic2.0−1
D05Rating of Drug Plan873.0+1
D06Getting Needed Prescription DrugsNot enough data available—
D07MPF Price Accuracy994.0−1
D08Medication Adherence for Diabetes Medications88%2.0−2
D09Medication Adherence for Hypertension (RAS antagonists)91%4.0±0
D10Medication Adherence for Cholesterol (Statins)91%4.0±0
D11Statin Use in Persons with Diabetes (SUPD)84%2.0±0
D12Concurrent Use of Opioids and Benzodiazepines (COB)10%4.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)5%5.0—

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