There are lots of encouraging signs for Medicare Advantage plans in the 2013 star ratings that CMS released today, but reaching the top five-star rating seems almost as tough as ever. Only 11 of what CMS calls Medicare Advantage prescription drug (MA-PD) plans got five stars for 2013, and they include three Medicare cost plans, while another four of what CMS calls MA-only plans got that rating. The comparable figures for 2012 were nine and 12, respectively. The number of 4.5-star MA plans climbed to 54 for 2013 from 46 in 2012, according to CMS, and the number of four-star plans advanced to 62 from 51. The average star rating weighted by enrollment for MA-PDs in 2013 is 3.66, up from 3.44 in 2012, the agency added.
This is the good news. The less good news is that there still are 62 MA plans with ratings below three stars, and that 10 MA contracts have had those ratings for three or more consecutive years and are getting the low-performer icon on CMS's website. And MA contracts with four or more stars in the South and Southeast remain a rarity, albeit less so than in 2012. Moreover, some star-rating measures are relative nightmares for MA plans, led by osteoporosis management, in which the average score was 1.4 stars, lower than any average score in the continuing 2012 measures. In addition, while two of the MA-PDs earning five stars this time are for-profit, not-for-profit plans continue to dominate the top-scorer list.
What do you think about the new ratings? Are the ratings reflective of what is happening in MA plan quality? Is the path toward ratings of four stars and above something most plans now can attain? And will it be feasible for three-star plans to keep operating after the CMS star bonus demonstration program ends in 2014? Is the glass half full or half empty?
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