CMS Releases 2019 Part C & D Star Ratings

The Centers for Medicare and Medicaid Services (CMS) has released its 2019 Medicare Part C and D Star Ratings. The star ratings program ranks plans on a quality of one to five stars, with one being the lowest and five being the highest ratings. Plans that earn consistently high ratings are paid bonuses. The ratings are based, in part, on plan performance in breast and colorectal cancer screenings, diabetes care, reduction in fall risks, flu vaccinations, hospital readmissions, and improvement and maintenance of physical and mental health. Additional considerations include the results of long-term conditions affecting the elderly.  In 2019, CMS reports that most beneficiaries will be able to select plans with at least four stars.

According to CMS, the Star Ratings allow beneficiaries to consider both quality and cost when making enrollment decisions while searching on the Medicare Plan Finder (MPF) within the Medicare.gov website. CMS also announced that plans that are consistently low performing will be disabled within the system.

As announced last April, beginning in 2019, CMS will remove one measure of calculation used in the star rating, known as the Beneficiary Access and Performance Problems measure. Feedback suggested that the measurement of CMS sanctions, civil penalties, notices of noncompliance, and warning and corrective action plans were not consistent, and that the different methodologies used made it difficult to make a fair assessment. Despite overall insurer support, critics claim that the removal of the BAPP measurement could potentially harm Medicare Advantage beneficiaries. CMS announced that a new method is being developed to answer concerns.

Below are the 2019 Five Star Rated Plans:

Five Star Rated Plans for Medicare Advantage and Part D

1. Kelsey-Seybold Plan Administrators
   2. Kaiser Foundation Health Plan
   3. Humana’s Careplus Health Plans
   4. Guidewell’s Health Options
   5. Kaiser Foundation Health Plan (different contract)
   6. Medical Associates Health Plan (MA only)
   7. Kaiser Foundation Health Plan of The Mid-Atlantic States
   8. Kaiser Foundation Health Plan of The Mid-Atlantic States (different contract)
   9. Tufts Associated Health Maintenance Organization
   10. Humana’s Cariten Health Plan
   11. Care Wisconsin Health Plan
   12. Cigna’s Healthspring of Florida
   13. Anthem’s Healthsun Health Plans
   14. Martin’s Point Generations Advantage
   15. Gundersen Health Plan of Minnesota

Five Star Rated Plans Part D only 

1. Anthem, Blue Cross Blue Shield of Massachusetts, BCBS of Rhode Island, BCBS of Vermont

2. Excellus Health Plan
   3. Independent Health Benefits Corp.
   4. Wellmark Iowa and South Dakota, BCBS of Minnesota, Montana, Nebraska, Nevada and Wyoming

To view the Medicare Part C & D Star Ratings: Update for 2019 released August 8, 2018 (Part C& D User Group Call) click HERE.

List Source: Becker’s Healthcare

Note: Due to CMS ratings grouped by contracts (with contracts that have multiple plans), some plans are repeated or grouped together.