Wednesday, October 15, 2014

Behind the 2015 Star-Ratings Release: An Exercise in Patience and Rolling With the Punches


By James Gutman - October 10, 2014

Waiting for the new Medicare Advantage (MA) and stand-alone Prescription Drug Plan (PDP) star ratings is a little like what people in my old New York City neighborhood used to call — in their politically incorrect way — “Chinese water torture.” CMS first lets plans see their own ratings for the coming year and comment on them, and then makes some general remarks about the ratings for the following year when it releases the so-called “landscape files” for MA and PDP plans in September. Finally, on a date in October that is sometimes changed at the last minute, the agency releases all the star-rating files so that plans having the stamina to penetrate huge ZIP files can see what befell their competitors and perhaps change their own marketing for the Annual Election Period (AEP) to reflect this.

The 2015 star ratings season that culminated Oct. 10 with the release of the new ratings reflected all of this drama — and more. In the 2015 landscape files announcement Sept. 18, CMS teased plans by disclosing that 40% of all MA contracts will receive a rating of four or more stars (up about six percentage points from 2014), meaning they stand to get quality bonuses, and that 60% of MA beneficiaries are now in plans that will get four or more stars for 2015 (up eight percentage points from 2014).

Plans usually are advised to keep their mouths shut about their ratings between the time they receive these vital data and the time the ratings officially are released, but sometimes the temptations prove just too much. Humana Inc. CEO Bruce Broussard, for instance, couldn’t resist telling a CAPG Physicians in Medicare Advantage conference audience in Washington, D.C., Oct. 8 that one of its plans had earned a five-star rating for 2015 and that the company’s average star rating had climbed again compared with the year-ago level.

The “torture” continued when CMS indicated it planned to release and post the new star ratings during office hours Oct. 9 but didn’t, pushing it back one day and thus giving plans one day less to make marketing adjustments for the AEP that starts Oct. 15. Meanwhile, though, enough of the data apparently was placed on the Medicare Plan Finder late Oct. 9 that securities analyst Christine Arnold was able to analyze them for six large publicly held MA insurers in a research note sent early Oct. 10.

Finally, at about 11 a.m. Oct. 10, the files appeared on the CMS link. They showed 16 five-star plans (three of them PDPs) and seven MA-PD plans that were given CMS’s low-performer icon (LPI) for having received summary or overall ratings of less than three stars for at least three years in a row. There were few surprises on either list, as shown, for instance, by five Kaiser Permanente plans getting the top rating and by plans for disadvantaged populations dominating the LPI list.

What do you think of the star-ratings dissemination process? How could it be improved? Does the timing of the stars release give insurers enough time to adjust their AEP marketing if they do some planning in advance? What might you do differently to avoid being “tortured” next year?

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