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12 Leading Medicare Advantage Payers by 2020 CMS Star Ratings
These twelve Medicare Advantage payers earned the highest scores in Medicare Advantage Star Ratings going into 2020, a year that has tested Medicare Advantage plans.
Going into what would be a tumultuous year for Medicare, twelve Medicare Advantage payers proved to be leaders in their field with five-star Medicare Advantage Star Ratings.
In a recent post, Matt Eyles, president and chief executive officer of America’s Health Insurance Plans (AHIP), underscored the pivotal role that Medicare Advantage plans have played in 2020. These plans cover over 24 million American lives and have strong bipartisan support across Congress. They have also proven crucial to the coronavirus response efforts.
“In a time when so much is dividing us, Americans know these programs deliver improved care, quality, and value for every single patient and taxpayer,” Eyles wrote.
Leading into 2020, twelve payers rose above the rest with their Medicare Advantage-prescription drug plans.
These plans earned five stars from CMS for delivering high quality service to their members according to 45 quality measures. For Medicare Advantage-prescription drug plans, CMS assesses quality measures such as screenings, member experience, chronic disease management, and more.
The data showed that Medicare Advantage plans continued to grow more competitive going into 2020, with the average star rating hovering around 4.16. This rise in competition may have been aided by the October 2019 executive order giving plans more flexibility with benefits and changes to payment models.
The year boasted 20 five-star Medicare Advantage-prescription drug plans, a slight decrease from 2018.
This list does not include plans that are solely prescription drug plans or Medicare Advantage-only plans.
Kaiser Foundation Health Plan
Kaiser Foundation Health Plan had seven plans earn a five-star rating, the payer with the highest number of five-star Medicare Advantage plans. Nearly half of these (three plans) had not earned a five-star rating last year.
The payer had more than 1.5 million enrollees in these plans as of October 2019. These enrollees were largely in non-employer group health plans, with the exception of one plan in Georgia. Other states that these plans covered included California, Colorado, Hawaii, Maryland, Virginia, and Washington.
UnitedHealth Group
UnitedHealth Group had two five-star Medicare Advantage plans.
One was located in Texas and served 53 counties there as a non-group health plan. The other, Care Improvement Plus South Central Insurance Co, served a single county in New York and most of the country as an employer group health plan.
Neither of these had earned five stars last year.
University of Wisconsin Hospitals and Clinics Authority
University of Wisconsin Hospitals and Clinics Authority had two five-star Medicare Advantage plans.
Quartz Health Plan Corporation had almost 16,800 enrollees as of October 2019. It served counties in Iowa, Illinois, and Wisconsin as a non-employer group health plan. The plan did not earn this number of stars the prior year.
Quartz Health Plan Mn Corporation served another 1,772 enrollees in three counties in Minnesota as a non-employer group health plan.
Humana
Humana’s Careplus Health Plan received five stars for its service to nearly 138,600 members. It served 18 counties in Florida as a non-employer group health plan.
Tufts Health Plan
Tufts Health Plan’s five-star Medicare Advantage plan, the Tufts Associated Health Maintenance Organization, served ten counties in Massachusetts. As of October 2019, it had slightly more than 102,200 enrollees. It did not offer employer group health plans.
Guidewell Mutual Holding Corporation
Guidewell, a member of the Blue Cross Blue Shield Association, had almost 68,000 enrollees in its five-star plan, Florida Blue Medicare. It had nearly a matched number of non-employer group health plan service areas (31 counties) and employer group health plan service areas (36 counties).
Anthem
Anthem had one Medicare Advantage plan receive five stars, its Healthsun Health Plans. This plan served three counties in Florida as a non-employer group health plan. Its enrollment encompassed 48,646 enrollees.
CIGNA
Cigna’s Healthspring of Florida Medicare Advantage plan served both non-employer group health plans (17 counties) and employer group health plans (50 counties) in Florida. The plan had over 48,100 enrollees. This plan had also been awarded five stars the previous year.
Kelsey-Seybold Medical Group
Ks Plan Administrators is Kelsey-Seybold Medical Group’s five-star Medicare Advantage plan. Located in Texas, the plan served almost 35,000 members in 13 non-employer group health plan counties and almost every county in Texas as an employer group health plan.
CVS Health Corporation
CVS Health’s Aetna Health Inc. (me) Medicare Advantage plan earned five stars for 2020. It had over 8,900 people enrolled in the plan as of October 2019. It had a non-employer group health plan service area spanning 16 counties in Maine and its employer group health plan was available across most of the nation.
HealthPartners
Group Health Plan is HealthPartners’s five-star Medicare Advantage plan in midwestern and northwestern states. The plan served over 5,900 enrollees as a non-employer group health plan in 53 counties across Minnesota, North Dakota, South Dakota, and Wisconsin, but mostly in Minnesota. It served one county in Wisconsin as an employer group health plan.
It did not receive a five-star rating the previous year.
Martin’s Point Health Care
Martin’s Point Health Care had one Medicare Advantage health plan that achieved a five-star rating: Martin's Point Generations Advantage, Inc. The plan did not receive a five-star rating last year.
The plan had 1,725 enrollees and served every county in Maine and New Hampshire as a non-employer group health plan.
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