Contract
S5975
Moda Health Plan, Inc. · 2027 Star Ratings
MODA HEALTH PLAN, INC. · PDP
Parent: Moda Partners, Inc.
Summary ratings
Overall
Not Applicable
2026: Not Applicable—
Part C · health plan
Not Applicable
2026: Not Applicable—
Part D · drug plan
4.0
2026: 3.0+1.0
2027 footprint
This contract has no plans in the CMS 2027 landscape file (employer-only, PDP, or not offered for 2027).
- Members, Sep 2026
- 55K
Domain stars
| Domain | 2027 | 2026 | Change |
|---|---|---|---|
| HD1Staying Healthy: Screenings, Tests and Vaccines | Plan not required to report measure | Plan not required to report measure | — |
| HD2Managing Chronic (Long Term) Conditions | Plan not required to report measure | Plan not required to report measure | — |
| HD3Member Experience with Health Plan | Plan not required to report measure | Plan not required to report measure | — |
| HD4Member Complaints and Changes in the Health Plan's Performance | Plan not required to report measure | Plan not required to report measure | — |
| HD5Health Plan Customer Service | Plan not required to report measure | Plan not required to report measure | — |
| DD1Drug Plan Customer Service | Not enough data available | Not enough data available | — |
| DD2Member Complaints and Changes in the Drug Plan's Performance | 5.0 | 4.0 | +1.0 |
| DD3Member Experience with the Drug Plan | 5.0 | 5.0 | ±0 |
| DD4Drug Safety and Accuracy of Drug Pricing | 3.0 | 3.0 | ±0 |
Part C measures · health plan
| Measure | 2027 result | 2027 stars | vs 2026 |
|---|---|---|---|
| C01Breast Cancer Screening | Plan not required to report measure | — | |
| C02Colorectal Cancer Screening | Plan not required to report measure | new spec | |
| C03Annual Flu Vaccine | Plan not required to report measure | — | |
| C04Improving or Maintaining Physical Health | Plan not required to report measure | — | |
| C05Improving or Maintaining Mental Health | Plan not required to report measure | — | |
| C06Monitoring Physical Activity | Plan not required to report measure | — | |
| C07Special Needs Plan (SNP) Care Management | Plan not required to report measure | — | |
| C08Care for Older Adults – Medication Review | Plan not required to report measure | — | |
| C09Care for Older Adults - Functional Status Assessment | Plan not required to report measure | — | |
| C10Osteoporosis Management in Women who had a Fracture | Plan not required to report measure | — | |
| C11Diabetes Care – Eye Exam | Plan not required to report measure | — | |
| C12Diabetes Care – Blood Sugar Controlled | Plan not required to report measure | — | |
| C13Kidney Health Evaluation for Patients with Diabetes | Plan not required to report measure | — | |
| C14Controlling High Blood Pressure | Plan not required to report measure | — | |
| C15Reducing the Risk of Falling | Plan not required to report measure | — | |
| C16Improving Bladder Control | Plan not required to report measure | — | |
| C17Plan All-Cause Readmissions | Plan not required to report measure | — | |
| C18Statin Therapy for Patients with Cardiovascular Disease | Plan not required to report measure | — | |
| C19Transitions of Care | Plan not required to report measure | — | |
| C20Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | Plan not required to report measure | — | |
| C21Getting Needed Care | Plan not required to report measure | — | |
| C22Getting Appointments and Care Quickly | Plan not required to report measure | — | |
| C23Customer Service | Plan not required to report measure | — | |
| C24Rating of Health Care Quality | Plan not required to report measure | — | |
| C25Rating of Health Plan | Plan not required to report measure | — | |
| C26Care Coordination | Plan not required to report measure | — | |
| C27Complaints about the Health Plan | Plan not required to report measure | — | |
| C28Members Choosing to Leave the Plan | Plan not required to report measure | — | |
| C29Health Plan Quality Improvement | Plan not required to report measure | — | |
| C30Plan Makes Timely Decisions about Appeals | Plan not required to report measure | — | |
| C31Reviewing Appeals Decisions | Plan not required to report measure | — | |
| C32Call Center – Foreign Language Interpreter and TTY Availability | Plan not required to report measure | — | |
Part D measures · drug plan
| Measure | 2027 result | 2027 stars | vs 2026 |
|---|---|---|---|
| D01Call Center – Foreign Language Interpreter and TTY Availability | Not enough data available | — | |
| D02Complaints about the Drug Plan | 0.02 | 5.0 | ±0 |
| D03Members Choosing to Leave the Plan | Not enough data available | — | |
| D04Drug Plan Quality Improvement | Medicare shows only a Star Rating for this topic | 4.0 | +1 |
| D05Rating of Drug Plan | 87 | 4.0 | ±0 |
| D06Getting Needed Prescription Drugs | 91 | 5.0 | ±0 |
| D07MPF Price Accuracy | Plan not required to report measure | — | |
| D08Medication Adherence for Diabetes Medications | 89% | 3.0 | ±0 |
| D09Medication Adherence for Hypertension (RAS antagonists) | 89% | 3.0 | +1 |
| D10Medication Adherence for Cholesterol (Statins) | 89% | 3.0 | ±0 |
| D11Statin Use in Persons with Diabetes (SUPD) | 84% | 4.0 | ±0 |
| D12Concurrent Use of Opioids and Benzodiazepines (COB) | 7% | 4.0 | — |
| D13Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) | 8% | 1.0 | — |