The Centers for Medicare and Medicaid Services (CMS) released its official report card for the Medicare Advantage and Part D plans on Oct. 10. The Medicare Advantage and Part D plans are ranked on a quality scale of one to five stars, with five meaning excellent and one a poor performance.
Most beneficiaries will be able to select a Medicare Advantage or Part D plan with at least four stars in 2019. CMS is removing star rating units for Medicare Advantage plans beginning in 2019 as well.
It will remove the Beneficiary Access and Performance Problems (BAPP) measure from its star rating calculations. The BAPP measure uses CMS’ sanctions, civil money penalties, and compliance data.
Medicare analyzes how health plans performs on measures like the following: breast cancer screening, colorectal cancer screening, annual flu vaccine, improving or maintaining physical health, improving or maintaining mental health, monitoring physical activity, and adult body mass index assessment.
Medicare uses information from member satisfaction surveys, plans, and health care providers to decide overall performance star ratings. Medicare updates their ratings every fall for the following year. These ratings can change each year.
CMS uses a five-star quality ranking system to rank. They are the following:
- Plan outcomes
- Patient experience with plans
- Access to the plans
- Process to sign up for the plan and working with the plan
Medicare Advantage (with Part D) Plans with 5 Stars
- Kelsey-Seybold Plan Administrators
- Kaiser Foundation Health Plan
- Humana’s Careplus Health Plans
- Guidewell’s Health Options
- Kaiser Foundation Health Plan
- Medical Associates Health Plan
- Kaiser Foundation Health Plan of The Mid-Atlantic States
- Kaiser Foundation Health Plan of The Mid-Atlantic States
- Tufts Associated Health Maintenance Organization
- Humana’s Cariten Health Plan
- Care Wisconsin Health Plan
- Cigna’s Healthspring of Florida
- Anthem’s Healthsun Health Plans
- Martin’s Point Generations Advantage
- Gundersen Health Plan of Minnesota
Part D only plans with 5 stars
- Anthem, Blue Cross Blue Shield of Massachusetts, BCBS of Rhode Island, BCBS of Vermont
- Excellus Health Plan
- Independent Health Benefits Corp.
- Wellmark Iowa and South Dakota, BCBS of Minnesota, Montana, Nebraska, Nevada and Wyoming
