More plans earn high marks in 2016 Medicare Advantage Star Ratings

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The 2016 Medicare Advantage Star Ratings are out, and the results show an improvement year over year in the number of high-performing plans.

About 49 percent of Medicare Advantage plans with Part D prescription drug coverage (MA-PDs) earned four stars or higher for their 2016 rating, up from 40 percent of MA-PDs that did so for the 2015 ratings, according to a fact sheet from the Centers for Medicare & Medicaid Services (CMS).

When the data is weighted for enrollment, it shows that nearly 71 percent of MA-PD enrollees have plans with four or more stars. This statistic in particular shows steady improvement, as the share of enrollees in four-stars-or-higher plans was 60 percent last year and 52 percent the year before, FierceHealthPayer has reported.

Seventeen MA plans this year earned the highest rating--five stars--seven of which are new to the top ranks: Cigna Healthcare of Arizona Inc., Tufts Associated Health Maintenance Organizations, Group Health Plan Inc., Essence Healthcare Inc., Medical Associates Clinic Health Plan, Sierra Health and Life Insurance Company Inc. and Tufts Insurance Company. Last year, 16 plans earned a five-star rating.

In terms of the low performers, the fact sheet identifies six plans that it deems "consistently low performers," or those that have earned fewer than three stars for their MA or Part D summary rating for at least the last three years. These are: Wellcare of Louisiana Inc., Sierra Health and Life Insurance Company Inc., Touchstone Health HMO Inc., Cuatro LLC, Windsor Health Plan Inc. and GHS Managed Health Care Plans Inc.

Wellcare Health Plans Inc., which owns two of these low performers, has previously criticized the ratings system, saying it unfairly penalizes insurers with dual-eligible members.

CMS notes that "on average, higher Star Ratings are associated with more experience in the MA program. We see a similar pattern for [prescription drug plans]." In addition, organizations that are non-profit tend to receive higher ratings than those that are for-profit.

CMS uses its Star Ratings system to guide consumers on its Medicare Plan Finder site as well as determine its MA Quality Bonus Payments. What's more, previous research has linked higher Star Ratings with greater enrollment in MA plans, as consumers increasingly choose plans with four or more stars.

To learn more:
- here's the fact sheet (.pdf)

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