Industry Observers Note Massive Move to MA Plans with Higher Star Quality Ratings in AIS Newsletter

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Analysts tell Atlantic Information Services’s Medicare Advantage News that the trend can be attributed to the better benefits and reduced costs the higher-rated plans can afford to offer because of the rebate dollars that plans rated four stars or above get from CMS.

Now that the 2015 Medicare open enrollment period has ended and the Centers for Medicare & Medicaid Services has released partial enrollment data, one trend has become abundantly clear, industry analysts tell Atlantic Information Services, Inc.’s (AIS) Medicare Advantage News (MAN) in its Jan. 22 issue: there has been a massive move from Medicare Advantage (MA) plans with lower CMS star quality ratings to those with higher ratings. One major insurer with higher average star ratings, for example, saw a 6% MA enrollment increase while several others with lower average star ratings had smaller membership gains or even reductions. Analysts tell MAN that they attribute this to the better benefits and reduced costs the higher-rated plans can afford because of the rebate dollars that plans rated four stars or above get from CMS.

While the overall MA enrollment figures show small gains, Eric Hammelman, a vice president at Avalere Health, LLC, suggests that the more important data are the “phenomenal” differences in the performance of high- versus low-star-rated plans in this enrollment period, since CMS has put an end to awarding bonuses to plans with ratings below four stars. That means for “two plans in the same county with close to the same bids and costs, the higher-star plan could get twice as many rebate dollars” from CMS, Hammelman asserts.

Visit to read the article in its entirety, including analysis of other trends observed during this enrollment period.

About Medicare Advantage News
Medicare Advantage News is the health care industry’s #1 source of timely news and business strategies about Medicare Advantage plans, product design, marketing, enrollment, market expansions, CMS audits, and countless federal initiatives in this hotly contested area of health insurance. Published biweekly since 1994 (when it was Medicare+Choice), the newsletter exists to help plans boost revenues, increase enrollees, cut costs and improve outcomes in Medicare Advantage and Medicaid managed care. Visit for more information.

About AIS    
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at

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Jill Brown, Executive Editor
Atlantic Information Services
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