Contract
H2563

Sentara Medicare · 2027 Star Ratings

SENTARA HEALTH PLANS · Local CCP · offers special needs plans

Parent: Sentara Health Care (SHC)

Summary ratings

Overall
3.0
2026: 3.5−0.5
Part C · health plan
2.5
2026: 3.0−0.5
Part D · drug plan
4.0
2026: 4.0±0

2027 footprint

Members, Sep 2026
571
2027 plans
1
Open to all ($0 premium)
0 (0)
Counties
133
Special needs plans
Dual-Eligible
Drug coverage
Yes
VA

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines3.03.0±0
HD2Managing Chronic (Long Term) Conditions2.02.0±0
HD3Member Experience with Health PlanNot enough data available3.0—
HD4Member Complaints and Changes in the Health Plan's Performance4.04.0±0
HD5Health Plan Customer Service3.03.0±0
DD1Drug Plan Customer Service5.04.0+1.0
DD2Member Complaints and Changes in the Drug Plan's Performance4.04.0±0
DD3Member Experience with the Drug PlanNot enough data available4.0—
DD4Drug Safety and Accuracy of Drug Pricing3.03.0±0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening84%5.0+1
C02Colorectal Cancer Screening66%2.0new spec
C03Annual Flu VaccinePlan too small to be measured—
C04Improving or Maintaining Physical Health66%1.0−1
C05Improving or Maintaining Mental Health80%1.0±0
C06Monitoring Physical Activity55%4.0±0
C07Special Needs Plan (SNP) Care Management61%2.0+1
C08Care for Older Adults – Medication Review91%3.0+1
C09Care for Older Adults - Functional Status Assessment76%2.0—
C10Osteoporosis Management in Women who had a Fracture36%2.0+1
C11Diabetes Care – Eye Exam69%2.0±0
C12Diabetes Care – Blood Sugar Controlled86%3.0±0
C13Kidney Health Evaluation for Patients with Diabetes58%2.0−1
C14Controlling High Blood Pressure71%1.0−1
C15Reducing the Risk of Falling56%2.0−1
C16Improving Bladder Control45%3.0+1
C17Plan All-Cause Readmissions11%3.0+1
C18Statin Therapy for Patients with Cardiovascular Disease86%3.0±0
C19Transitions of Care58%3.0+1
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions57%2.0±0
C21Getting Needed CarePlan too small to be measured—
C22Getting Appointments and Care QuicklyPlan too small to be measured—
C23Customer ServicePlan too small to be measured—
C24Rating of Health Care QualityPlan too small to be measured—
C25Rating of Health PlanPlan too small to be measured—
C26Care CoordinationPlan too small to be measured—
C27Complaints about the Health Plan0.264.0±0
C28Members Choosing to Leave the Plan0%5.0+1
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0−1
C30Plan Makes Timely Decisions about Appeals97%3.0±0
C31Reviewing Appeals Decisions92%2.0±0
C32Call Center – Foreign Language Interpreter and TTY Availability98%4.0±0

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability100%5.0+1
D02Complaints about the Drug Plan0.264.0±0
D03Members Choosing to Leave the Plan0%5.0+1
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0−1
D05Rating of Drug PlanPlan too small to be measured—
D06Getting Needed Prescription DrugsPlan too small to be measured—
D07MPF Price Accuracy1005.0±0
D08Medication Adherence for Diabetes Medications88%2.0−1
D09Medication Adherence for Hypertension (RAS antagonists)90%4.0+1
D10Medication Adherence for Cholesterol (Statins)89%3.0±0
D11Statin Use in Persons with Diabetes (SUPD)85%2.0−1
D12Concurrent Use of Opioids and Benzodiazepines (COB)10%4.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)9%3.0—

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