More five-star Medicare Advantage plans as coverage improves, CMS says
Overall, the 369 private Medicare contracts for 2016 fared better in the ratings than in 2015.
The Centers for Medicare and Medicaid continues to see improvement in the number of beneficiaries enrolled in high-performing Medicare Advantage plans, according to its 2016 Star Ratings released on October 8.
The ratings determine Medicare Advantage quality bonus payments.
They range from two stars to five in half increments, with a rating of four stars or greater necessary to receive a 5 percent per-member payment from Medicare.
[Also: CMS rolls out new value-based Medicare Advantage program]
Overall, the 369 private Medicare contracts for 2016 fared better in the ratings than in 2015.
Close to half, 49 percent of the Medicare Advantage-Prescription Drug plans that will be active in 2016 earned four stars or higher, according to CMS. This is a 9 percent increase from 40 percent earning four stars or higher in 2015.
Of the 369 Medicare Advantage contracts, 17 reached five star status in three different plans.
[Also: Medicare Advantage premiums to inch lower in 2016 as enrollment climbs, CMS says]
In the Medicare Advantage Prescription Drug plan, 12 were rated as five stars, compared to 11 that reached that level in three previous years.
In 2016, three Medicare Advantage-only plans and two prescription drug or Part D plans reached the five star rating, according to the report.
The 12 Medicare Advantage Prescription Drug plans that reached five star status are: Cigna Healthcare of Arizona; Kaiser Foundation in California; Kaiser Foundation in Colorado; Kaiser Foundation in Hawaii; Kaiser Foundation of the mid-Atlantic states; the Kaiser Foundation in Oregon and Washington; Tufts Associated Health Maintenance Organization in Massachusetts; Group Health Plan in Minnesota and Wisconsin; Essence Healthcare in Illinois and Missouri; Gundersen Health Plan in Iowa and Wisconsin; Martin's Point Generations in Maine and New Hampshire; and Sierra Health and Life Insurance Company in Colorado, Kansas, Massachusetts, Maryland, Michigan, New Jersey, Pennsylvania, Texas and Virginia.
[Also: More oversight needed for Medicare Advantage plans, General Accountability Office says]
The three Medicare Advantage-only plans receiving the five star rating are Medical Associates Health Plan in Iowa and Illinois; Medical Associates Clinic Health Plan in Wisconsin; and Dean Health Plan in Wisconsin.
The two prescription drug plans out of 59 contracts that received the highest rating are: Tufts Insurance Company and Wisconsin Physician Service Insurance Corporation. The ratings show room for improvement in prescription Part D plans. In 2013, four plans received five star ratings, and there were 70 contracts.
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CMS continues to lower the overall star rating for contracts with serious compliance issues.
The six low performing plans in the 2016 report are: Wellcare of Louisiana; Sierra Health and life Insurance Company operated by UnitedHealth Group; Touchstone Health HMO; Cuatro LLC; Windsor Health Plan operated by Wellcare; and GHS Managed Health Care Plans operated by Health Care Service Corporation.
The Centers for Medicare and Medicaid Services publishes the Part C and D Star Ratings each year to measure quality in Medicare Advantage and Prescription Drug Plans.
The star ratings measures span five broad categories that have weighted measures: outcomes, intermediate outcomes, patient experience, access and process.
Twitter: @SusanJMorse
