MetroPlusHealth Achieves Major Quality Milestones across Medicare, Medicaid, and Specialized Care Programs
From a 4-Star Medicare rating to New York State’s number one-ranked HIV Special Needs Plan, MetroPlusHealth continues to deliver outstanding outcomes for New Yorkers
Oct 29, 2026
MetroPlusHealth, New York City’s high-quality, affordable health plan, today announced a series of major quality achievements across its Medicare, Medicaid, HIV Special Needs Plan (HIV SNP), and Health and Recovery Plan (HARP) programs, underscoring its commitment to delivering high-quality, equitable care for New Yorkers. Together, these accomplishments highlight MetroPlusHealth’s continued success in improving member health outcomes, enhancing the member experience, and advancing health equity through its integrated partnership with NYC Health + Hospitals.
“These remarkable achievements reflect the extraordinary dedication of our teams, providers, and community partners who work every day to help New Yorkers live healthier lives,” said Dr. Talya Schwartz, President and Chief Executive Officer of MetroPlusHealth. “Whether serving older adults, individuals living with HIV, members with behavioral health needs, or families enrolled in Medicaid and the Essential Plan, our mission remains the same: to deliver high-quality, member-centered care that helps our communities thrive.”
Delivering Results Across the Organization
- Medicare: For the second consecutive year, MetroPlusHealth earned an overall 4-Star Medicare Rating from the Centers for Medicare & Medicaid Services, including 4 Stars for Part C and 4.5 Stars for Part D prescription drug coverage. The rating reflects strong performance across 45 measures evaluating clinical quality, member experience, pharmacy services, and operations.
- HIV Special Needs Plan: MetroPlusHealth ranked number one among New York State HIV Special Needs Plans for the fourth consecutive year in the HIV SNP Quality Incentive Program. The plan earned the highest overall score among participating plans, achieving a quality score of 91.76 and a total score of 80.4. It also earned all 45 points available for viral load suppression—the program’s most heavily weighted measure and a critical indicator of effective HIV treatment and long-term health outcomes for people living with HIV. This achievement reinforces MetroPlusHealth’s longstanding leadership in HIV care and its commitment to connecting members with specialized care management, community outreach, and treatment services.
- Medicaid: MetroPlusHealth achieved Tier 1, the highest performance tier available, in New York’s Medicaid Quality Incentive Award program for Measurement Year 2024. The plan earned credit on 32 of 36 quality measures, achieving 90th-percentile performance on 11 measures spanning preventive care, behavioral health, maternal health, and chronic disease management. These results reflect broad-based improvements in delivering high-quality care for MetroPlusHealth’s Medicaid and Child Health Plus members.
- Health and Recovery Plan (HARP): MetroPlusHealth earned back 100% of the available quality withhold under New York’s Health and Recovery Plan quality program for Measurement Year 2024, following similarly strong performance in Measurement Year 2023. This accomplishment reflects the program’s success in supporting members with significant behavioral health needs, integrating physical, mental health, and substance use services, and highlights MetroPlusHealth’s care management, care coordination, and member support.
Together, these outcomes demonstrate MetroPlusHealth’s ability to deliver exceptional results across multiple lines of business while serving one of the nation’s most diverse member populations. Through ongoing partnerships with NYC Health + Hospitals and community provider partners, MetroPlusHealth continues to improve member outcomes, strengthen the member experience, advance health equity, and create value for the communities it serves.
“Quality is at the center of everything we do,” said Dr. Schwartz. “These achievements show what’s possible when we invest in coordinated, equitable, and evidence-based care. Most importantly, they represent better health, better experiences, and better outcomes for the members and communities we serve.”
For more information, please visit metroplus.org.
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MEDIA CONTACT: Michelle Dominguez, MetroPlusHealth
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About MetroPlusHealth
MetroPlusHealth is a wholly owned subsidiary of NYC Health + Hospitals. For more than 40 years, MetroPlusHealth has provided access to affordable, quality health care to the people of New York City. It is a leader in addressing social determinants of health and the only New York State plan to dedicate resources specifically to ensuring members have access to food, housing, and transportation. MetroPlusHealth serves nearly 700,000 members across New York City and its impressive network includes more than 34,000 providers and more than 40 hospitals and urgent care centers, including NYC Health + Hospitals, NYU Langone, Mount Sinai, CityMD, Montefiore, LabCorp, Lenox Hill Radiology, Memorial Sloan Kettering, Hospital for Special Surgery, and more. For more information about MetroPlusHealth, please visit https://metroplus.org/.
About NYC Health + Hospitals
NYC Health + Hospitals is the largest public health care system in the nation serving more than a million New Yorkers annually in more than 70 patient care locations across the city’s five boroughs. A robust network of outpatient, neighborhood-based primary and specialty care centers anchors care coordination with the system’s trauma centers, nursing homes, post-acute care centers, home care agency, and MetroPlusHealth—all supported by 11 essential hospitals. Its diverse workforce of more than 46,000 employees is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible. For more information, visit www.nychealthandhospitals.org and stay connected on Facebook, Twitter, Instagram and LinkedIn.