Contract
H3384

Highmark Blue Cross Blue Shield or Highmark Blue S · 2027 Star Ratings

Highmark Western and Northeastern New York Inc. · Local CCP

Parent: Highmark Health

Summary ratings

Overall
4.0
2026: 4.0±0
Part C · health plan
3.5
2026: 4.0−0.5
Part D · drug plan
3.5
2026: 4.5−1.0

2027 footprint

Members, Sep 2026
23K
2027 plans
12
Open to all ($0 premium)
12 (4)
Counties
18
Special needs plans
None
Drug coverage
Yes
NY

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines4.04.0±0
HD2Managing Chronic (Long Term) Conditions4.03.0+1.0
HD3Member Experience with Health Plan3.04.0−1.0
HD4Member Complaints and Changes in the Health Plan's Performance4.04.0±0
HD5Health Plan Customer Service4.03.0+1.0
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 Plan3.03.0±0
DD4Drug Safety and Accuracy of Drug Pricing4.04.0±0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening84%5.0+1
C02Colorectal Cancer Screening81%4.0new spec
C03Annual Flu Vaccine72%5.0+1
C04Improving or Maintaining Physical Health74%4.0±0
C05Improving or Maintaining Mental Health88%5.0±0
C06Monitoring Physical Activity43%1.0−3
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 Fracture46%3.0−1
C11Diabetes Care – Eye Exam83%4.0±0
C12Diabetes Care – Blood Sugar Controlled94%5.0±0
C13Kidney Health Evaluation for Patients with Diabetes72%4.0±0
C14Controlling High Blood Pressure82%3.0±0
C15Reducing the Risk of Falling54%2.0±0
C16Improving Bladder Control48%4.0+2
C17Plan All-Cause Readmissions11%3.0+1
C18Statin Therapy for Patients with Cardiovascular Disease92%4.0−1
C19Transitions of Care76%4.0+1
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions64%3.0±0
C21Getting Needed Care834.0−1
C22Getting Appointments and Care Quickly854.0−1
C23Customer Service893.0±0
C24Rating of Health Care Quality862.0−2
C25Rating of Health Plan842.0−1
C26Care Coordination863.0−1
C27Complaints about the Health Plan0.075.0±0
C28Members Choosing to Leave the Plan1%5.0+1
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic2.0−2
C30Plan Makes Timely Decisions about Appeals95%3.0±0
C31Reviewing Appeals Decisions100%5.0+1
C32Call Center – Foreign Language Interpreter and TTY Availability100%5.0+2

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability100%5.0+1
D02Complaints about the Drug Plan0.075.0±0
D03Members Choosing to Leave the Plan1%5.0+1
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic1.0−3
D05Rating of Drug Plan842.0±0
D06Getting Needed Prescription Drugs893.0−1
D07MPF Price Accuracy994.0−1
D08Medication Adherence for Diabetes Medications89%3.0−1
D09Medication Adherence for Hypertension (RAS antagonists)92%4.0−1
D10Medication Adherence for Cholesterol (Statins)91%4.0±0
D11Statin Use in Persons with Diabetes (SUPD)93%4.0−1
D12Concurrent Use of Opioids and Benzodiazepines (COB)12%4.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)6%4.0—

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