Average MA Star Ratings Fall; United, Anthem See Big Drops

Reprinted with AIS Health permission from the Oct. 9, 2020, issue of Health Plan Weekly. Star ratings for Medicare Advantage plans declined across the board for 2021, signaling an overall drop of around 5.5% in the number of members enrolled in contracts with 4 or...

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Health Leaders on Adopting Personalized Medicine Quickly

Health Leaders on Adopting Personalized Medicine Quickly

This week, we attended roundtable discussions with Chief Medical Officers and C-level executives from leading health plans on personalized Medicine. Part of the focus was on what health executives can do to get personalized medicine adopted more...

Medicare Advantage Plans at Start of Data Tsunami

Medicare Advantage Plans at Start of Data Tsunami

CMS Administrator Seema Verma announced in April that the agency has released Medicare Advantage encounter data to researchers. (Encounter data are records of the health care services for which managed care organizations pay.)  It was reported that...

1/100th of a Star Rating Point Could Mean Survival

1/100th of a Star Rating Point Could Mean Survival

Some Medicare Advantage plans scored a 3.74 and were rounded to the “nearest half Star” based on Centers for Medicare & Medicaid Services (CMS) rules, so the plan was rated a 3.5.  Conversely, other plans were scored 3.75 and were rounded to...

The Medicare Advantage VBID Plan Administrative Challenge

The Medicare Advantage VBID Plan Administrative Challenge

CMS started its VBID (value-based insurance design) innovation model for Medicare Advantage on January 1, 2017 to run for five years. Eligible Medicare Advantage plans can offer “varied plan benefit design” for enrollees based on specified clinical...