CMS Names Medicare Advantage Plan Stars

Margaret Dick Tocknell, for HealthLeaders Media , October 17, 2012

The addition of Humana-Wisconsin among the 5-star plans marks the first time a for-profit health plan has cracked the top tier. In recent years Humana, WellPoint, and other for-profit plans have actively pursued improvement in their star ratings.

Last year, during a conference call with analysts, Michael McCallister, Humana's chair of the board and CEO, said Humana "plans to reinvest heavily in improving our stars' processes, procedures and infrastructure to position us for further improvements in star metrics."

Meanwhile, WellPoint has high hopes that CareMore, the Medicare Advantage plan it acquired last year, will lead to higher quality star ratings. This year CareMore posted 3.5 stars.

The star program is not without its detractors. The nonpartisan Government Accountability Office has expressed concerns about the CMS's authority to offer the bonuses. The GAO contends that the existing program is much more generous than the bonus program outlined in PPACA.

That could be but the combination of the carrot (money) and stick (loss of members) seems to have health plans taking notice.

Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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