Contract
H4279

UPMC for Life Complete Care · 2027 Star Ratings

UPMC FOR YOU, INC · Local CCP · offers special needs plans

Parent: UPMC Health System

Summary ratings

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

2027 footprint

Members, Sep 2026
37K
2027 plans
4
Open to all ($0 premium)
0 (0)
Counties
62
Special needs plans
Dual-Eligible
Drug coverage
Yes
PA

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines2.02.0±0
HD2Managing Chronic (Long Term) Conditions3.03.0±0
HD3Member Experience with Health Plan5.04.0+1.0
HD4Member Complaints and Changes in the Health Plan's Performance4.04.0±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 Performance4.04.0±0
DD3Member Experience with the Drug Plan5.05.0±0
DD4Drug Safety and Accuracy of Drug Pricing3.04.0−1.0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening66%2.0±0
C02Colorectal Cancer Screening68%3.0new spec
C03Annual Flu Vaccine57%2.0±0
C04Improving or Maintaining Physical HealthNot enough data available—
C05Improving or Maintaining Mental HealthNot enough data available—
C06Monitoring Physical Activity41%1.0−1
C07Special Needs Plan (SNP) Care Management69%3.0±0
C08Care for Older Adults – Medication Review94%3.0−1
C09Care for Older Adults - Functional Status Assessment93%4.0—
C10Osteoporosis Management in Women who had a Fracture16%1.0−1
C11Diabetes Care – Eye Exam75%3.0±0
C12Diabetes Care – Blood Sugar Controlled89%4.0+1
C13Kidney Health Evaluation for Patients with Diabetes62%2.0−1
C14Controlling High Blood Pressure84%4.0+1
C15Reducing the Risk of Falling64%3.0−2
C16Improving Bladder Control43%3.0−1
C17Plan All-Cause Readmissions9%4.0±0
C18Statin Therapy for Patients with Cardiovascular Disease89%4.0+1
C19Transitions of Care78%4.0±0
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions73%4.0±0
C21Getting Needed Care844.0±0
C22Getting Appointments and Care Quickly854.0±0
C23Customer Service925.0±0
C24Rating of Health Care Quality894.0±0
C25Rating of Health Plan915.0±0
C26Care Coordination905.0+2
C27Complaints about the Health Plan0.135.0±0
C28Members Choosing to Leave the Plan9%4.0±0
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0±0
C30Plan Makes Timely Decisions about Appeals99%4.0−1
C31Reviewing Appeals Decisions99%4.0+1
C32Call Center – Foreign Language Interpreter and TTY Availability94%3.0−1

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability92%3.0−1
D02Complaints about the Drug Plan0.135.0±0
D03Members Choosing to Leave the Plan9%4.0±0
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic2.0±0
D05Rating of Drug Plan905.0±0
D06Getting Needed Prescription Drugs904.0−1
D07MPF Price Accuracy994.0−1
D08Medication Adherence for Diabetes Medications89%3.0−1
D09Medication Adherence for Hypertension (RAS antagonists)89%3.0−1
D10Medication Adherence for Cholesterol (Statins)89%3.0−1
D11Statin Use in Persons with Diabetes (SUPD)87%3.0±0
D12Concurrent Use of Opioids and Benzodiazepines (COB)18%2.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)16%1.0—

Other UPMC Health System contracts

  • H3907UPMC for Life4.5★
  • H5533UPMC for Life4.5★
  • S3389UPMC Health Plan4.0★
  • H7123UPMC for Life Complete Care3.0★