Member: RADAR on Medicare Advantage

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2020 Star Ratings Show Bulk of Enrollees Are in High Star Plans

with Chart: More Than 80% of MA-PD Members Are Enrolled in a Highly Rated Plan, Latest Star Ratings Show

October 17, 2019

According to CMS’s recent release of the 2020 star quality ratings, an overwhelming percentage of Medicare Advantage beneficiaries continue to enroll in plans with 4 or more stars. There was also a notable shift of membership into highly rated Prescription Drug Plans, some of which made meaningful improvements on an individual basis even though PDP performance on average was stagnant.

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AEP Campaigns Focus on Member Experience, New Benefits

October 17, 2019

As Medicare Advantage benefits get richer and more complex and competition continues to grow, marketing campaigns around the Medicare Annual Election Period (AEP) are becoming more of a year-round affair. MA organizations large and small are focused on providing an end-to-end member experience — from the first point of contact with the plan to their first utilization of new supplemental benefits — and investing in a variety of ways to forge bonds with customers, several marketing experts tell AIS Health.

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Exec Order Includes Possible Boost for Rarely Used MSAs

October 17, 2019

In an executive order released earlier this month, President Trump laid out several directives for the HHS secretary aimed at protecting Medicare for seniors while strengthening the Medicare Advantage program and providing more plan choices. These included actions that could loosen restrictions on MA benefits and plan designs, revise network adequacy standards to include more telehealth, and encourage the growth of rarely used Medicare Medical Savings Accounts (MSAs).

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Trump Directs HHS to Consider Filling MA Network Gaps With Telehealth

October 17, 2019

In addition to expanding Medicare coverage options such as Medical Savings Accounts (see story, p. 3), President Trump’s recent executive order (EO) on Medicare directed HHS to propose a regulation that would improve beneficiary access to providers and plans by “adjusting network adequacy requirements for MA plans to account for: (a) the competitiveness of the health market in the States where such plans operate…and (b) the enhanced access to health outcomes made possible through telehealth services or other innovative technologies.”

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News Briefs

October 17, 2019

✦ A UnitedHealthcare subsidiary serving about 42,000 Medicare Advantage Prescription Drug (MA-PD) plan members was barred from enrolling new beneficiaries this Annual Election Period for a failure to maintain a medical loss ratio (MLR) of at least 85%. According to a CMS letter dated Sept. 11 and recently posted to the CMS Part C and Part D Enforcement Page, Care Improvement Plus South Central Insurance Co. reported MLRs of 71.3% for calendar year 2016, 83.9% for CY 2017, and 84.1% for CY 2018. As a result, it will be removed from the list of MA-PD plans available for selection on the Medicare Plan Finder for 2020. If the plan submits a CY 2019 report next year that indicates it has achieved an MLR of at least 85%, it will be allowed to accept enrollments for 2021, said CMS. Visit www.cms.gov.

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