Radar on Medicare Advantage
-
2023 Stars Signal Return to Normal, With Some Caveats
A little over half of Medicare Advantage Prescription Drug (MA-PD) contracts that will be offered in 2023 received an overall rating of 4 stars or higher, according to Medicare Parts C and D Star Ratings data released by CMS on Oct. 6. As expected, the new ratings reflect a return to normal after adjustments made for the COVID-19 public health emergency (PHE) resulted in a staggering 70% of MA-PD plans earning 4 stars or higher for 2022, compared with 49% of plans in 2021. But as the market becomes more saturated across the country, industry experts are watching closely to see whether recent steps taken by CMS to penalize poor performers will really level-set the market or demonstrate that more changes are needed to ensure members enroll in high-quality plans.
-
As Expected, Top MA-PD Payers See Star Ratings Declines
The average star rating for Medicare Advantage Prescription Drug (MA-PD) plans declined following the phaseout of pandemic-related flexibilities, according to CMS. While 72% of MA-PD beneficiaries are enrolled in a contract that is rated at least 4 stars for 2023, that’s down from an all-time high of 90% in 2022. These drops were anticipated however, as CMS in 2022’s ratings qualified all contracts under an “extreme and uncontrollable circumstances” policy to account for the COVID-19 public health emergency (PHE), which allowed payers to pick “best of” scores on many measures. Also, for 2023, the agency assigned a greater weight to member experience measures based largely on contracts’ Consumer Assessment of Healthcare Providers and Systems, after CMS suspended the collection of CAHPS survey data during the PHE.
-
Top Stars Performers Credit Coordinated Messaging, Targeted Outreach
As CMS resumed normal Star Ratings calculations and gave greater weight to patient experience measures, the proportion of Medicare Advantage Prescription Drug (MA-PD) earning 4 stars or higher for 2023 saw a dramatic drop from 2022, according to newly released CMS data. In an AIS Health series on successful Star Ratings strategies, top performers highlight connecting the dots around medication adherence, maintaining a year-round focus on member experience, and helping members navigate and utilize their benefits as key priorities. And while member outreach is a critical part of those initiatives, successful plans are careful to avoid overcommunicating with members and creating message fatigue, sources tell AIS Health, a division of MMIT.
-
SCAN Aims to Serve Aging LGBTQ+ Population With Affirm Product
As the Oct. 15 start date of the 2023 Medicare Annual Election Period (AEP) approached, insurers across the country this month unveiled new-and-improved benefits and major market expansions aimed at capturing share of the ever-growing Medicare Advantage market. And while Long Beach, Calif.-based SCAN Health Plan is offering enhanced benefits while pursuing new markets, it’s also gaining attention for launching a novel product specifically geared toward LGBTQ+ older adults. Company executives tell AIS Health, a division of MMIT, that the nonprofit insurer spent more than a year carefully shaping the product to ensure that it would meet the needs of the LGBTQ+ community, and it will continue to tweak the product as it gathers feedback from enrollees.
-
News Briefs: CMS Issues Warning to MAOs About 'Secret Shopping,' Misleading TV Ads During AEP
As the Medicare Annual Election Period gets underway, CMS is warning Medicare Advantage organizations and Prescription Drug Plan sponsors that it will be closely monitoring marketing activities during and beyond the AEP, including through “secret shopping” activities. Given increasing concerns about the marketing practices of all entities, including third-party marketing organizations, CMS has engaged in secret shopping by calling numbers associated with television advertisements, mailings, newspaper ads and internet searches, according to an Oct. 19 memo. CMS said it discovered that some agents are not complying with current rules and are “unduly pressuring beneficiaries, as well as failing to provide accurate or enough information to assist a beneficiary in making an informed enrollment decision.”
The Latest
Complimentary Publications
Premium Categories
Premium Categories
Meet Our Reporters
Meet Our Reporters