Medicare Advantage open enrollment begins Tuesday, and the Trump administration says that most beneficiaries will be enrolling in a plan with at least four stars.
The Centers for Medicare & Medicaid Services released the MA plan star ratings for the 2020 plan year, and the agency said 81% of beneficiaries with drug coverage will be in a plan that earned a rating of four stars or more. In addition to the star ratings, CMS has touted lower premiums compared to 2019—a decline of about 14%—and an overhauled Medicare Plan Finder that aims to make it easier for beneficiaries to compare their options.
That’s up significantly from 2017, when 69% of beneficiaries were enrolled in a plan with a rate of at least four stars, CMS said. The star rating scores, which are on a five-star scale, are based on clinical factors such as chronic disease management alongside member experience and customer service measures.
Kaiser Permanente once again leads the charge on the ratings. Kaiser’s plans earned an average of 4.6 out of five, slightly down from 2019 but still far ahead of the competition.
CMS Administrator Seema Verma said in a statement that strengthening Medicare Advantage has been a key focus for the administration, and referenced an executive order signed last week by President Donald Trump on the matter.
“Thanks to the president’s leadership and commitment, the improvements that CMS has made to the Medicare Advantage and Part D programs means that seniors will have access to more high-quality plans,” Verma said.
More than half (52%) of MA plans have a rating of four stars or higher, CMS said. That's compared to 45% in the 2019 plan year. The average rating overall for 2020 is 4.16 out of 5 stars, up from 4.09 stars in 2017.
How individual insurers performed
Kaiser is a distant first, earning three five-star ratings on plans and four 4.5 ratings. One of its plans had a four-star rating.
UnitedHealthcare leads the pack for national insurers, earning an average of 3.9 stars across 55 plan offerings, an analysis of the star ratings data by FierceHealthcare shows, using an average of all ratings listed for contracts by CMS. Close on UHC’s heels are Cigna and Anthem, which both earned an average of 3.8 stars for the 2020 plan year.
Cigna, in particular, is looking to make a splash in the MA market, as it launches its largest ever expansion in the sector for 2020 and is eyeing further growth down the road.
No major insurer dropped below an average of three stars for 2020. Looking at performance from an enrollment-weighted calculation, as included in analyst notes from JPMorgan Chase, boosts scores for the big names: Humana earns a 4.1 average; UnitedHealthcare, Aetna and Anthem earn a 4.0 score; and WellCare earns a 3.7.
Under this model, it indicates that most of MA's covered lives will be in plans with high-quality. Humana, for example, will cover 92% of its members under a plan with four or more stars, the insurer said.
Dan Mendelson, co-founder of the healthcare consulting firm Avalere, told FierceHealthcare that while a five-star rating is certainly the goal, a plan that earns a four or 4.5 score is “operating efficiently as Medicare wants it to run” as well.
The star ratings are “really one of the only objective things consumers can rely on to assess quality in the plans that they’re selecting,” he said.
Graphic designed by Paige Minemyer