MA Plans with Prescription Drug Coverage Star Ratings Average 4.16
Medicare Advantage plans with prescription drug coverage increased their average star ratings to 4.16 stars as new policies focus on heightening competition.
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- Medicare Advantage plans with prescription drug coverage (MA-PD) star ratings demonstrate that these plans are flourishing in distribution and, most of all, quality, CMS announced when it released the 2020 Medicare Advantage Star Ratings.
“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,” said CMS Administrator Seema Verma in the press release.
Each year, CMS reviews quality and performance measures for its plans. After receiving commentary from stakeholders, CMS chose not to add any measures for 2020. It analyzed 45 quality measures for Medicare Advantage and prescription drug (MA-PD) plans, 33 measures for MA plans, and 14 measures for PDP plans.
Fifty-two percent of all 210 MA-PD plans received four stars or above for 2020. Based on 2019 enrollment, CMS found that 81 percent of MA-PD plan enrollees will be in a plan rated four stars or more, which is 12 percentage points higher than it was in 2017. CMS data demonstrated the even distribution of high-quality MA-PD plans nationally.
Twenty of the 23 five-star rated plans were MA-PD plans, as were all nine new names on the five-star ratings list for 2020. Overall, MA-PD plans received on average 4.16 stars, an increase from 4.02 in 2017.
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Both Kaiser Foundation Health Plans and UnitedHealth Group boasted more than one five-star plan. Three of the top-ranked plans were Kaiser Foundation Health Plans from Colorado, Georgia, and Washington. Two were UnitedHealth Group plans.
Five-star MA-PD plans varied in size. Seven of the plans were between one thousand and twenty thousand enrollees in October of 2019. Five were between 20,000 and 50,000, five were over 100,000, and the remaining three were between 50,000 and 100,000.
Plans like UnitedHealth Group’s and Kaiser Foundation’s that earned five stars did not necessarily do so because they are large, but because they are well-established. CMS found that 6.45 percent of MA-PD plans that had been operating for ten years or more had five stars. In comparison, only 1.28 percent of those with five or fewer years in MA-PD were a five-star plan—that translates to only one plan out of the 20 MA-PD that received a perfect score.
Apart from Medicare Advantage plans, stand-alone prescription drug plans (PDPs) also saw improvements.
Sixteen PDPs, amounting to 30 percent of the total number of PDPs, obtained four stars or above and 28 percent of PDP enrollees will be in a four-star PDP. When plans with 3.5 or more stars are included, the number of enrollees rises to 42 percent of total PDP enrollment.
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Two PDPs achieved five stars. Both companies—Anthem and Lifetime Healthcare—have over ten years of experience in the PDP market. They also offer employer sponsored insurance in around 30 counties, which is more than seventeen of the MA-PD contracts did. However, successful MA-PD plans with four stars or higher tend to be available across most of the nation.
Though PDPs did not see high ratings, those ratings have been increasing since 2017. In 2019, the average stand-alone prescription drug plan received a 3.34-star rating. In 2020, the average star rating was 3.50. Thus, PDPs saw a slightly higher increase in star rating average in the past year at 0.16 than MA-PD plans – which improved by 0.14 – have seen in the past three years.
The 2020 Medicare Advantage Star Ratings come in the midst of heightened attention around growing Medicare Advantage plans, particularly since President’ Trump’s latest executive order (EO).
The order aimed at heightening competition between MA plans and leveling the playing field between MA plans and Medicare, but its potential effects are as yet a mystery.
In accordance with the EO, HHS Secretary Alex Azar will release proposed regulation to leverage MA plan competition by decreasing barriers to plan access through regulation and by supporting and expanding telehealth services. The proposed rules will also enhance MA benefits, design, and payment models.
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“Many of the EO’s provisions lack specifics, making it difficult to predict what, if any, policies or recommendations may emerge,” wrote Lindsey Copeland, federal policy director at the Medicare Rights Center. “Since any policies that do emerge would likely require legislative or regulatory action before taking effect, the EO’s prospects for impacting the program are also unknown.”
CMS, however, has expressed confidence that its policies will have a positive effect on the future of Medicare Advantage. Whereas in 2018 CMS anticipated a six percent drop in premiums for 2019, the agency now expects premiums to drop over twice that amount (14 percent) for open enrollment.
As the industry prepares for open enrollment this week, it also awaits the proposed HHS rules to see what next year could bring.
