Local PPO · observed 2026 → 2026 · 75 months of CPSC history · 1 active CY 2025 plans.
| Plan | Category | Premium | MOOP | ★ | Counties | Enrollment |
|---|---|---|---|---|---|---|
| Óptimo Plus (PPO) H4005/004 | MA-PD | $0 | $6,751 | 3.5 | 78 | 2,508 |
| ID | Measure | ★ |
|---|---|---|
| C01 | Breast Cancer Screening | 4.0 |
| C02 | Colorectal Cancer Screening | 5.0 |
| C03 | Annual Flu Vaccine | 1.0 |
| C04 | Monitoring Physical Activity | 4.0 |
| C05 | Special Needs Plan (SNP) Care Management | — |
| C06 | Care for Older Adults � Medication Review | — |
| C07 | Care for Older Adults � Pain Assessment | — |
| C08 | Osteoporosis Management in Women who had a Fracture | — |
| C09 | Diabetes Care � Eye Exam | 5.0 |
| C10 | Diabetes Care � Blood Sugar Controlled | 5.0 |
| C11 | Controlling High Blood Pressure | 5.0 |
| C12 | Reducing the Risk of Falling | 4.0 |
| C13 | Improving Bladder Control | 5.0 |
| C14 | Medication Reconciliation Post-Discharge | 3.0 |
| C15 | Plan All-Cause Readmissions | 2.0 |
| C16 | Statin Therapy for Patients with Cardiovascular Disease | 2.0 |
| C17 | Transitions of Care | 1.0 |
| C18 | Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 2.0 |
| C19 | Getting Needed Care | 1.0 |
| C20 | Getting Appointments and Care Quickly | 3.0 |
| C21 | Customer Service | 2.0 |
| C22 | Rating of Health Care Quality | 4.0 |
| C23 | Rating of Health Plan | 4.0 |
| C24 | Care Coordination | 3.0 |
| C25 | Complaints about the Health Plan | 5.0 |
| C26 | Members Choosing to Leave the Plan | 5.0 |
| C27 | Health Plan Quality Improvement | 4.0 |
| C28 | Plan Makes Timely Decisions about Appeals | — |
| C29 | Reviewing Appeals Decisions | — |
| C30 | Call Center � Foreign Language Interpreter and TTY Availability | 4.0 |
| D01 | Call Center � Foreign Language Interpreter and TTY Availability | 4.0 |
| D02 | Complaints about the Drug Plan | 5.0 |
| D03 | Members Choosing to Leave the Plan | 5.0 |
| D04 | Drug Plan Quality Improvement | 2.0 |
| D05 | Rating of Drug Plan | 5.0 |
| D06 | Getting Needed Prescription Drugs | 3.0 |
| D07 | MPF Price Accuracy | 3.0 |
| D08 | Medication Adherence for Diabetes Medications | 4.0 |
| D09 | Medication Adherence for Hypertension (RAS antagonists) | 4.0 |
| D10 | Medication Adherence for Cholesterol (Statins) | 2.0 |
| D11 | MTM Program Completion Rate for CMR | 5.0 |
| D12 | Statin Use in Persons with Diabetes (SUPD) | 3.0 |
No incoming transitions for this contract.