Health Insurance Report™ helps you track and analyze legal, legislative, and regulatory developments affecting the health-insurance industry throughout implementation of the Affordable Care Act...
Eleven Medicare Advantage plans received top quality ratings for 2013 from the Centers for Medicare & Medicaid Services, up from nine plans in 2012, according to data released Oct. 12 on the agency's website.
The rankings are based on 48 quality measures, including preventive screenings, managing chronic conditions, and patient experience. CMS gives bonuses to plans for higher-quality ratings, which help restore some of the Medicare Advantage reimbursement cuts in the Affordable Care Act.
The MA plans that received an “overall” score of five stars for “excellent performance,” which includes both the plans' Part D drug rating and Part C health care rating, are:
• Group Health Plan Inc., Minnesota and Wisconsin;
• Group Health Cooperative, Washington state;
• Gundersen Lutheran Health System Inc., Wisconsin;
• Humana Wisconsin Health;
• Baystate Health Inc.'s Health New England, Massachusetts; and
• Kaiser Foundation Health Plans available in California, Hawaii, Colorado, Oregon/Washington, Ohio, and the Mid-Atlantic region.
According to CMS Deputy Administrator Jonathan Blum, the agency has been shifting to weighing outcomes and patient experience measures more than other measures.
CMS said Medicare beneficiaries in 2013 will have access to 26 four- or five-star prescription drug plans, which currently serve 18 percent of enrollees. This is an improvement from 2012, in which 13 four- or five-star plans are serving only 9 percent of enrollees.
CMS said beneficiaries will also have access to 127 four- or five-star Medicare Advantage plans, which will serve 37 percent of MA enrollees and may attract more with their improved quality ratings. In 2012, people with Medicare had access to 106 four- or five-star plans, which served only 28 percent of enrollees, CMS said.
The five-star rating provides bonus funds and additional marketing privileges to the highest-rated plans. Five-star plans receive payment bonuses of up to 5 percent additional reimbursement and 10 percent in certain “double bonus” counties.
Blum said CMS will continue to allow the highest-rated plans to market and enroll beneficiaries throughout the year. He said the agency will also make it difficult for beneficiaries to sign up for plans ranked at three stars or less. Those beneficiaries currently enrolled in low-ranked plans will receive notifications to let them know how they can change to a higher-quality plan if they choose to do so.
By Nathaniel Weixel
CMS's performance data files are at http://www.cms.gov/PrescriptionDrugCovGenIn/06_PerformanceData.asp.
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to firstname.lastname@example.org.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to email@example.com.
Put me on standing order
Notify me when new releases are available (no standing order will be created)