Medicare Advantage star ratings show little change
The CMS released star ratings for Medicare Advantage (MA) and Part D prescription drug plans Wednesday that showed a dip in the number of top-ranking plans.
The number of MA enrollees in plans with four or more stars, however, has increased to about 73% from last year's 69%.
In other MA news, Cleveland Clinic and Anthem Blue Cross and Blue Shield in Ohio announced they will offer a new plan called Anthem MediBlue Prime Select. The partnership is Cleveland Clinic’s third with payers this year, including an MA offering with Humana and an Affordable Care Act (ACA) exchange and individual health insurance plan with Oscar.
Payers have been embracing the MA market recently, and with more baby boomers hitting retirement age, they see a growth opportunity. Many insurers have found more investment in MA is paying off. Humana has pulled out the ACA exchanges entirely to focus on MA plans, and UnitedHealth Group said recently it expects that eventually half of all Medicare beneficiaries will be in MA.
Insurers strive for high ratings to entice more enrollees and for the potential financial rewards. Top-rated plans (those with four or five stars) get a 5% quality bonus. For 2018, the number of plans receiving that bonus is 44%, down from 49% in 2017.
The CMS recently announced that Medicare enrollees will have more choices and lower premiums in 2018, which is the opposite of what’s been happening in the ACA exchanges. CMS Administrator Seema Verma, who is considered a top candidate for the next HHS secretary, is an outspoken supporter of Medicare programs but has opposed the ACA exchanges.
The number of MA plans with prescription drug coverage receiving three and a half stars was 139, while 98 plans earned four stars and 26 earned five stars. No insurers were named as consistently low performers this year.The CMS said Medicare Part D plans are improving. About 47% of Part D enrollees in standalone prescription drug plans will have plans with four or five stars.
Blues insurance company Anthem celebrated the release of the star ratings. Anthem said in a press release that more than 60% of its MA members will be in plans with four stars or better. The payer saw its highest percentage of top-rated plans since the Medicare star ratings program began.
Anthem CEO Joseph Swedish said the improved numbers are linked to a “commitment to improve the performance and quality” of its Medicare offerings. Anthem said the company has made “considerable investments” in Medicare programs, broadened its product portfolio and deepened provider and member engagement.
“As a result of these initiatives, Anthem anticipates more meaningful growth in its Medicare business in 2018, compared to previous years,” according to the release.
Meanwhile, Centene is not so happy. The payer plans to appeal its subsidiary Health Net of California's lower rating in 2018. Health Net of California dropped from four stars to three and a half stars. Centene said the rating dropped because of a penalty associated with a plan audit in 2015.
The latest ratings come after the CMS decided to not continue with its October update to make changes to its hospital star rating methodology. The American Hospital Association (AHA) and other groups have spoken out about the hospital ratings program. The AHA has questioned the “reliability and accuracy” of the methodology to determine the ratings. In fact, some of the top hospitals in the U.S. have received average ratings in past years, while lower profile hospitals wound up with five stars.