The CMS databases showing Medicare Star ratings for Medicare Advantage (MA) and Medicare Prescription Drug Plans (PDP) are out. Analysis shows that CMS is keeping a tight reign on the number of 5-star plans, while allowing slightly more 4.5-star plans and significantly more 4-star plans in 2014.

Number of plans receiving each rating level

More MA plans, but fewer rated in 2014

There are 677 MA plans (664 MA-PD plans that include prescription coverage and 13 MA-only plans that do not include prescription coverage) listed in the 2014 report card, but only 437 of those plans received a star rating from CMS. In 2013, there were 578 total MA plans (563 MA-PD and 15 MA-only), with 454 of those plans being rated by CMS. The difference appears to be a large influx of new plans that have not been in existence long enough for CMS to measure member experiences and plan performance. There were 52 plans in the 2013 rating year that were designated as “too new to be rated” while there are 176 plans in the 2014 rating year with this designation.

A few changes at the top of the MA plan rankings

Four MA-PD plans and one MA-only plan slipped from 5-stars in 2013 to 4.5-stars for 2014. Conversely, four MA-PD plans managed to raise their scores from 4.5-stars to 5-stars over the same time period. No plan jumped a full star rating to attain the ranks of the 5-star plans and no former 5-star plan fell more than one-half star compared to 2013. In fact, four plans (HealthPartners, Humana, Kaiser of OH and Medical Associates of WI) have been straddling the fine line between a 4.5 and a 5.0 star rating for several years with each plan receiving 4.5-stars in 2012, then 5-stars in 2013 and 4.5-stars for 2014.

The five plans that lost their 5-star rating in 2014 are:

  • Humana WisconsinHealth Organization Insurance Corp
  • Health New England (HNE) Medicare Advantage Plans
  • HealthPartners (Group Health Plan of MN)
  • Kaiser Permanente of Ohio
  • Medical Associates Clinic Health Plan of Wisconsin (MA-only plan)

The MA plans that attained a 5-star rating for 2014 are:

  • Cigna-HealthSpring (FL) – new for 2014
  • Group Health Cooperative (WA)
  • Gundersen Health Plan, Inc. (WI)
  • Kaiser Foundation Health Plan, Inc. (CA)
  • Kaiser Foundation Health Plan, Inc. (CO)
  • Kaiser Foundation Health Plan, Inc. (GA) – new for 2014
  • Kaiser Foundation Health Plan, Inc. (HI)
  • Kaiser Foundation Health Plan of the Mid-Atlantic States (MD/VA)
  • Kaiser Foundation Health Plan of the Northwest (WA)
  • KelseyCare Advantage (TX) – new for 2014
  • Providence Health Plans (OR) – new for 2014
  • Dean Health Plan, Inc. (WI)
  • Kaiser Foundation Health Plan, Inc. (CA)
  • Medical Associates Health Plan, Inc. (IA & IL)

More volatility in PDP rankings

The number of Medicare prescription plans (PDPs) that received a 5-star rating increased from four to five and the number of PDPs receiving 4.5-stars increased from four to six from 2013 to 2014. The total number of PDPs also increased slightly from 79 in 2013 to 85 in 2014. While the overall counts for PDPs did not change significantly, the roster of 5-star plans did change dramatically with three new plans attaining the 5-star rating in 2014, two plans lost their 5-star rating (Excellus and Wellmark) and two other retained their 5-star rating from 2013. Two of the additions for 2014 are Employer/Union organizations (Missouri DOT and national Rural Electric Coop). PDPs either gained a full star rating to climb into the 5-star category or lost a full star rating to lose the coveted 5-star ranking from 2013.

  • Catamaran Insurance Of Delaware, Inc. (DE)
  • Hawaii Medical Service Association (HI)
  • Missouri Department of Transportation (MO) – new for 2014
  • National Rural Electric Cooperative Association (most of US) – new for 2014
  • Tufts Health Plan (MA) – new for 2014