CMS touts more highly-ranked MA prescription plans next year

Les Masterson | October 11, 2018

Dive Brief:
• Nearly three-fourths of Medicare Advantage enrollees with prescription drug coverage next year will have plans with either four or five stars ratings, CMS said Wednesday. That’s an increase of one percentage point over this year.

• Overall, about 45% of MA plans with prescription drug coverage will have overall ratings of at least four stars in 2019. Most areas of the country will have MA and Part D plans with at least four stars.

• Nearly one-third of stand-alone prescription drug plans will have a rating of at least four stars in 2019. Most enrollees in stand-alone prescription drug plans will be in plans with at least 3.5 stars, according to CMS.

Dive Insight:
CMS updates star ratings annually as a way to reward payers (more stars equals higher payments) and help consumers choose the best MA and Part D plans. Users can compare plans on Medicare Plan Finder.

David Windley, equity analyst at Jefferies, said in a note Wednesday that Centene and WellCare most improved their mix of MA lives qualifying for a 5% bonus, which is at least four stars. Humana and Cigna modestly improved, while Anthem, UnitedHealth and Aetna have a “lower mix of members in the bonus,” he said.

CMS Administrator Seema Verma said in a statement that MA plans next year will offer more quality with declining premiums and more choice for consumers.

CMS recently announced that MA premiums will decrease in 2019 by 6% to $28 a month. The Medicare Part D prescription drug program’s average monthly premium will decrease from $33.59 this year to $32.50 in 2019. CMS is implementing several changes, including low-cost generic drugs and increased competition among Part D plans and pharmacies.

The agency also promoted that there will be 600 more MA plans next year and expanded benefits. More than nine out of 10 Medicare beneficiaries will have access to at least 10 MA plans.

CMS is additionally trumpeting efforts to make enrollment easier for consumers. Its eMedicare initiative includes an improved “coverage wizard” that will compare options, including original Medicare and MA plans. People can also use an out-of-pocket calculator that includes overall costs and prescription drug costs.
Open enrollment for Medicare begins Monday and runs to Dec. 7. CMS expects MA beneficiaries will grow in 2019, with more than 36% of Medicare beneficiaries predicted to have an MA plan. The agency projected an 11.5% increase compared to 2018 with 22.6 million people expected in 2019.
Meanwhile, more payers have moved into the MA market. UnitedHealthcare and Humana remain the two largest insurers offering such plans, but other companies including Aetna, WellCare, Clover Health and Centene have expanded their footprints over the past year.
One reason for this interest is that payers have a steady stream of newly eligible, and usually healthy, Medicare recipients. These new members often have employer-based coverage, so there aren’t pent-up health costs.

Another possible driver of more competition is a new rule that will allow plans to offer a wider range of benefits, including non-medical options like food assistance and transportation to appointments. That could be a boon for population health-focused programs, which both payers and providers back.

Source:  Healthcare Dive

https://www.healthcaredive.com/news/cms-touts-more-highly-ranked-ma-prescription-plans-next-year/539370/