Elevance reports a drop in 2024 Medicare Advantage star ratings
The insurer was “disappointed” with the results, execs said.
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Elevance Health is “disappointed” with its performance on the 2024 Medicare Advantage star ratings, the insurer’s EVP and CFO John Gallina told investors during an earnings call this month.
The Centers for Medicare and Medicaid Services (CMS) uses quality metrics to rank Medicare Advantage contracts from one (lowest) to five (highest) stars. The best performers—i.e., those earning four or five stars—may receive bonus payments, so insurance companies benefit from the ratings system, Healthcare Brew previously reported.
About 34% of Elevance members are enrolled in contracts rated four stars or higher for 2024, down from close to 64% in 2023, according to the insurer’s regulatory filings. In 2024, Elevance’s three largest Medicare Advantage contracts, representing approximately 36% of the insurer’s Medicare Advantage members, will drop from four or 4.5 stars down to 3.5 stars, according to the filings.
The Indianapolis-based insurer also experienced a decline in Consumer Assessment of Healthcare Providers and Systems (CAHP) scores, which are some of the most heavily weighted measures in Medicare Advantage star ratings, Gail Boudreaux, Elevance president and CEO, said during the earnings call. CMS assigns these scores based on patient experience surveys.
The insurer plans to invest in four primary areas—service, product, network access, and operations—to help improve its performance in future years, Boudreaux said. For example, based on the CAHP scores, Elevance is focusing on scaling its My Health Advocate model, which helps members navigate their benefits and healthcare system, Boudreaux added.
“Collectively, these actions and the ongoing investments should enhance our performance in key star measures and ultimately increase member satisfaction with our plans,” she said.
Elevance isn’t the only insurer seeing a drop in star ratings.
About 42% of Medicare Advantage plans with prescription drug coverage in 2024 will receive four or more stars, down from approximately 51% of plans in 2023, according to CMS.
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Navigate the healthcare industry
Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.