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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