Sometimes there are good studies with findings that raise as many questions as they answer, and this might be the case with study results released by HealthPocket, Inc. June 25. HealthPocket found that there was a “moderate correlation” between Medicare Advantage plans’ star ratings and their voluntary member attrition rate. As the star ratings went up, the attrition rates went down. And the company, which operates a free website that compares and ranks health plans, found an even stronger correlation between MA plans’ complaint rates — as measured by CMS Complaints Tracking Module (CTM) data — and their attrition rates.
Steven Zaleznick, HealthPocket’s executive director for consumer strategy and development, makes clear the study didn’t attempt to find out whether either measure caused the attrition differences. But the findings do show almost straight-line relationships between both measures and attrition in 2013. This suggests that consumers may pay more attention to star ratings than many industry observers think and that CTMs are a more valid indicator of what plans are doing wrong than some industry executives think. But there may be other explanations as well.
There is a possibility, for instance, that since many high-star-rated plans earn those ratings largely because of their close ties with providers, the providers tend to speak better about those plans in front of their patients. The patients then might make enrollment decisions based on what their providers say without even knowing about the star ratings. Similarly, since high-star-rated MA plans get quality bonuses from CMS that must be used to either lower beneficiary cost sharing or increase benefits, the MA members may be reacting to lower premiums or better benefits rather than to the star ratings themselves.
How much of a cause-and-effect relationship do you think there is between star ratings (or CTMs) and member attrition? Are beneficiaries making decisions based largely on perceptions of plan quality, or is it just the dollars related to the stars that cause them to “vote with their feet” and leave plans? Have we actually entered an era in which health plan quality is understood and correctly measured, or are the stars still too far away for beneficiaries to see clearly?
http://aishealth.com/blog/medicare-advantage-and-part-d/which-came-first-chicken-or-star-rating
No comments:
Post a Comment