The Centers of Medicare and Medicaid Services has given an overall 4.5-star quality rating to Puerto Rico-based Triple-S Management Corp.'s 2019 Care Coordination Medicare Advantage plan.

The contract was upgraded from a four-star rating. The new rating will take effect in payment year 2020.

CMS' star ratings measure quality of care and member satisfaction with a health carrier. Preventive care, adherence to medications, hospital readmissions and the management of chronic conditions are factored into the rating.