Dive Brief:
- CMS released its 2020 ratings for Medicare Advantage and Part D plans, with various Kaiser Permanente plans getting the highest ratings.
- Many of the carriers were rated above average, but data was missing from many rural parts of the country.
- Of the 401 MA plans rated, about 52% of the plans that also offer drug benefits in 2020 earned four stars or higher, and roughly 81% of enrollees are in plans that will have four or more stars in 2020.
Dive Brief:
Thanks to the Affordable Care Act, the star ratings allow Medicare Advantage plans to earn lucrative bonuses when they nab higher ratings, which are based off quality and performance data.
MA plans that offer Part D drug coverage were tested on 45 different quality measures, while those without the prescription drug offering were only tested on 33 measures such as breast cancer screenings, customer service and making timely decisions on enrollee appeals.
Only five plans received a rating of less than three stars. They were Quality Health Plans of New York, Community Care Alliance of Illinois, Centers Plan for Healthy Living, Prominence HealthFirst of Texas and Merit Health Insurance Co. Merit, which is owned by Magellan Health, is the only one with a significant number of enrollees, with 63,495. The other plans have fewer than 10,000 enrollees combined.
Twenty plans that offer both Medicare Advantage and Part D received ratings of five stars, up from 14 in 2019.
Of those, seven were operated by Kaiser Foundation Health Plan in California, Washington state, Colorado, Georgia, Hawaii, Virginia, Maryland, and the District of Columbia. Quartz Health Plan, which operates in Illinois, Wisconsin and Minnesota, was the only other carrier to receive more than one five-star rating. Also included on the list was one MA-only carrier, Medical Associates Health Plan, which operates in Iowa, Illinois and Nebraska. Anthem and Excellus received the highest ratings for Part D-exclusive plans.
In 2019, four such plans received five stars.
UnitedHealthcare improved its star ratings position the most, according to Jefferies analyst David Windley. UnitedHealthcare was followed by Humana and CVS.
Both Centene and WellCare did not fare so well, coming as the two attempt to wrap up their merger.
"This is a less-than-inspiring performance by both sides of the proposed merger," Windley said in a note.
No data was provided on MA plans operating in mostly rural parts of the United States, including large parts of Northern California, Utah, Colorado, Wyoming and all of Alaska, according to data released by CMS.
Despite the gaps and the mostly anodyne ratings, CMS Administrator Seema Verma took the opportunity to issue a statement taking a swipe at proposals to turn Medicare into a universal system, arguing it "would eviscerate the progress we’ve made to strengthen the program by empowering patients to make informed choices."