Contract
H5828

Wellpoint · 2027 Star Ratings

WELLPOINT TENNESSEE, INC. · Local CCP · offers special needs plans

Parent: Elevance Health, Inc.

Summary ratings

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

2027 footprint

Members, Sep 2026
27K
2027 plans
9
Open to all ($0 premium)
6 (4)
Counties
95
Special needs plans
Dual-Eligible
Drug coverage
Yes
TN

Domain stars

Domain20272026Change
HD1Staying Healthy: Screenings, Tests and Vaccines2.02.0±0
HD2Managing Chronic (Long Term) Conditions2.02.0±0
HD3Member Experience with Health Plan4.03.0+1.0
HD4Member Complaints and Changes in the Health Plan's Performance3.03.0±0
HD5Health Plan Customer Service4.05.0−1.0
DD1Drug Plan Customer Service5.05.0±0
DD2Member Complaints and Changes in the Drug Plan's Performance3.03.0±0
DD3Member Experience with the Drug Plan4.04.0±0
DD4Drug Safety and Accuracy of Drug Pricing2.03.0−1.0

Part C measures · health plan

Measure2027 result2027 starsvs 2026
C01Breast Cancer Screening65%2.0±0
C02Colorectal Cancer Screening59%2.0new spec
C03Annual Flu Vaccine55%1.0−1
C04Improving or Maintaining Physical HealthNot enough data available—
C05Improving or Maintaining Mental HealthNot enough data available—
C06Monitoring Physical Activity42%1.0±0
C07Special Needs Plan (SNP) Care Management55%2.0±0
C08Care for Older Adults – Medication Review93%3.0−1
C09Care for Older Adults - Functional Status Assessment85%3.0—
C10Osteoporosis Management in Women who had a Fracture25%1.0±0
C11Diabetes Care – Eye Exam59%1.0−1
C12Diabetes Care – Blood Sugar Controlled80%2.0−1
C13Kidney Health Evaluation for Patients with Diabetes61%2.0−1
C14Controlling High Blood Pressure70%1.0−1
C15Reducing the Risk of Falling64%3.0−1
C16Improving Bladder Control39%2.0+1
C17Plan All-Cause Readmissions11%3.0+1
C18Statin Therapy for Patients with Cardiovascular Disease85%2.0±0
C19Transitions of Care71%4.0+1
C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions54%1.0−1
C21Getting Needed Care855.0+1
C22Getting Appointments and Care Quickly875.0+1
C23Customer Service903.0±0
C24Rating of Health Care Quality874.0+1
C25Rating of Health Plan863.0+1
C26Care Coordination895.0+2
C27Complaints about the Health Plan0.363.0±0
C28Members Choosing to Leave the Plan29%2.0±0
C29Health Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0+1
C30Plan Makes Timely Decisions about Appeals96%3.0−2
C31Reviewing Appeals Decisions100%5.0±0
C32Call Center – Foreign Language Interpreter and TTY Availability100%5.0±0

Part D measures · drug plan

Measure2027 result2027 starsvs 2026
D01Call Center – Foreign Language Interpreter and TTY Availability100%5.0±0
D02Complaints about the Drug Plan0.363.0±0
D03Members Choosing to Leave the Plan29%2.0±0
D04Drug Plan Quality ImprovementMedicare shows only a Star Rating for this topic4.0±0
D05Rating of Drug Plan884.0±0
D06Getting Needed Prescription Drugs904.0±0
D07MPF Price Accuracy994.0−1
D08Medication Adherence for Diabetes Medications86%2.0+1
D09Medication Adherence for Hypertension (RAS antagonists)86%2.0±0
D10Medication Adherence for Cholesterol (Statins)86%2.0±0
D11Statin Use in Persons with Diabetes (SUPD)85%2.0−1
D12Concurrent Use of Opioids and Benzodiazepines (COB)16%3.0—
D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)12%2.0—

Other Elevance Health, Inc. contracts

  • H4036Anthem Blue Cross and Blue Shield4.5★
  • H3447Anthem HealthKeepers3.0★
  • H3655Anthem Blue Cross and Blue Shield3.5★
  • H4471Anthem Blue Cross3.0★
  • H4004Medicare y Mucho Mas (MMM)4.5★
  • H4003Medicare y Mucho Mas (MMM)4.5★
  • H5427Freedom Health, Inc.4.0★
  • H9525Anthem Blue Cross and Blue Shield3.5★
  • H5594Optimum HealthCare, Inc.4.5★
  • H5431HealthSun Health Plans, Inc.4.5★
  • H8849Wellpoint3.5★
  • S5596Anthem Insurance Companies, Inc.3.0★