Contract
H3923

Capital Blue Cross · 2027 Star Ratings

CAPITAL ADVANTAGE INSURANCE COMPANY · Local CCP

Parent: CAPITAL BLUE CROSS

Summary ratings

Overall
4.0
2026: 4.5−0.5
Part C · health plan
4.0
2026: 4.5−0.5
Part D · drug plan
4.5
2026: 4.0+0.5

2027 footprint

Members, Sep 2026
42K
2027 plans
24
Open to all ($0 premium)
24 (9)
Counties
21
Special needs plans
None
Drug coverage
Yes
PA

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines3.04.0−1.0
HD2Managing Chronic (Long Term) Conditions3.04.0−1.0
HD3Member Experience with Health Plan5.04.0+1.0
HD4Member Complaints and Changes in the Health Plan's Performance5.05.0±0
HD5Health Plan Customer Service4.04.0±0
DD1Drug Plan Customer Service3.04.0−1.0
DD2Member Complaints and Changes in the Drug Plan's Performance5.05.0±0
DD3Member Experience with the Drug Plan4.03.0+1.0
DD4Drug Safety and Accuracy of Drug Pricing4.04.0±0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening80%4.0±0
C02Colorectal Cancer Screening80%4.0new spec
C03Annual Flu Vaccine67%4.0−1
C04Improving or Maintaining Physical Health72%3.0−2
C05Improving or Maintaining Mental Health83%3.0−1
C06Monitoring Physical Activity48%2.0−1
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 Fracture36%2.0±0
C11Diabetes Care – Eye Exam80%4.0+1
C12Diabetes Care – Blood Sugar Controlled89%4.0±0
C13Kidney Health Evaluation for Patients with Diabetes71%3.0−1
C14Controlling High Blood Pressure77%2.0−2
C15Reducing the Risk of Falling56%2.0−1
C16Improving Bladder Control41%2.0−1
C17Plan All-Cause Readmissions10%4.0+1
C18Statin Therapy for Patients with Cardiovascular Disease90%4.0+1
C19Transitions of Care81%5.0±0
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions62%2.0−1
C21Getting Needed Care845.0+1
C22Getting Appointments and Care Quickly875.0±0
C23Customer Service914.0±0
C24Rating of Health Care Quality895.0+1
C25Rating of Health Plan895.0+1
C26Care Coordination895.0±0
C27Complaints about the Health Plan0.115.0±0
C28Members Choosing to Leave the Plan4%5.0±0
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0±0
C30Plan Makes Timely Decisions about Appeals99%4.0±0
C31Reviewing Appeals Decisions99%4.0+1
C32Call Center – Foreign Language Interpreter and TTY Availability98%4.0−1

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability95%3.0−1
D02Complaints about the Drug Plan0.115.0±0
D03Members Choosing to Leave the Plan4%5.0±0
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0±0
D05Rating of Drug Plan884.0+2
D06Getting Needed Prescription Drugs914.0±0
D07MPF Price Accuracy1005.0±0
D08Medication Adherence for Diabetes Medications91%4.0±0
D09Medication Adherence for Hypertension (RAS antagonists)92%4.0±0
D10Medication Adherence for Cholesterol (Statins)91%4.0±0
D11Statin Use in Persons with Diabetes (SUPD)87%3.0±0
D12Concurrent Use of Opioids and Benzodiazepines (COB)15%3.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)6%4.0—

Other CAPITAL BLUE CROSS contracts

  • H3962Capital Blue Cross4.0★
  • S8067Avalon Insurance Company4.0★