Navigation Links
Higher quality rating for Medicare Advantage plan linked with increased likelihood of enrollment
Date:1/15/2013

CHICAGO In a study that included nearly 1.3 million Medicare beneficiaries who were either first-time enrollees or enrollees switching plans, researchers found a positive association between enrollment and publicly reported Medicare Advantage star ratings reflecting plan quality, according to a study appearing in the January 16 issue of JAMA.

"To inform enrollment decisions and spur improvement in the Medicare Advantage marketplace, the U.S. Centers for Medicare & Medicaid Services (CMS) provides star ratings reflecting Medicare Advantage plan quality. A combined Part C and D overall rating was created in 2011 for Medicare Advantage and prescription drug (MAPD) plans," according to background information in the article. The star ratings incorporate data from several sources. "In 2011, MAPD star ratings ranged from 2.5 to 5 stars. Only 3 MAPD contracts received 5 stars; some were unrated because they were too new or small," the authors write. "While star ratings clearly matter to insurers, it is unclear whether they matter to beneficiaries."

Rachel O. Reid, M.S., of the Centers for Medicare & Medicaid Services, Baltimore, and colleagues conducted a study to assess the association between publicly reported Medicare Advantage plan quality ratings and enrollment. Of the 7.6 million beneficiaries with an eligible 2011 MAPD enrollment, the study population consisted of 952,352 first-time enrollees and 322,699 enrollees switching plans. The analysis controlled for beneficiary and plan characteristics.

Among the key characteristics of included plans by star rating, the highest-rated plans more often had higher premiums, while unrated plans more often had higher out-of-pocket costs or were private fee-for-service or local PPO plans.

The researchers found that among first-time enrollees, higher star ratings were associated with increased likelihood to enroll in a given plan (9.5 percentage points per 1-star increase). The highest rating available to a beneficiary was associated with a 1.9 percentage-point increase in likelihood to enroll. Star ratings were less strongly associated with enrollment for the youngest, black, low-income, rural, and Midwestern enrollees.

Among beneficiaries switching plans, higher star ratings were associated with increased likelihood to enroll in a given plan (4.4 percentage points per 1-star increase). A star rating at least as high as a beneficiary's prior plan's rating was associated with a 6.3 percentage-point increase in likelihood to enroll. "Star ratings were less strongly associated with enrollment among the youngest, low-income, and rural beneficiaries and negatively associated among Midwestern beneficiaries. Compared with other races/ethnicities, star ratings were more strongly associated with enrollment for white beneficiaries," the authors write.

"We found a positive association between CMS's 5-star Medicare Advantage quality ratings and enrollment. Bolstering the business case for quality in the Medicare Advantage market, these findings may provide firms with additional incentive to cultivate higher quality, CMS with justification to continue to advance public reporting, and policy makers with a rationale to pursue quality reporting in other health insurance markets," the authors conclude.

(JAMA. 2013;309(3):267-274; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr. Shrank reported serving as a consultant to United Healthcare; and receiving grant support from CVS Caremark, Aetna, and Express Scripts. The other authors did not report any disclosures.

Please Note: For this study, there will be a digital news release available, including the JAMA Report video, embedded and downloadable video, audio files, text, documents, and related links. This content will be available at 3 p.m. CT Tuesday, January 15 at this link.

Editorial: Performance Ratings and Plan Selection by Medicare Beneficiaries

"Despite the limitations in this study, it is valuable to see some evidence that Medicare Advantage enrollees may be using ratings as one factor in making choices," writes Jack Hoadley, Ph.D., of Georgetown University, Washington, D.C., in an accompanying editorial.

"It is critical for the program to keep improving the available plan ratings and to make them increasingly available and relevant to the needs of consumers. Key questions for future study include what tools and what measures do consumers seek when they select plans? How do consumers use ratings as part of a plan selection strategy? How can the plan selection process be simplified and streamlined?"

(JAMA. 2013;309(3):287-288; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.


'/>"/>

Contact: Brian Cook
press@cms.hhs.gov
202-690-6145
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Depressed Stroke Survivors May Face Higher Early Death Risk
2. Teenagers with a low muscular strength have a higher risk of dying early form heart disease
3. Why are children at higher risk for negative health effects of environmental toxins?
4. Higher levels of obesity associated with increased risk of death
5. Chronic Worry Linked to Higher Risk of PTSD
6. Benefits of higher oxygen, breathing device persist after infancy
7. A New Review Reveals How “Jump Manual” Can Help People Jump Higher - Tony Nguyen
8. Daimer Debuts Carpet Cleaners For Car Dealerships Seeking Interior Auto Detailing Steam Cleaner Machines Featuring Higher Power and A Larger Water Capacity
9. Metro Atlanta ServiceMasters Team Up to Offer Higher Quality of Water Damage, Mold Removal, Carpet Cleaning and Fire Damage Services to Customers in North Georgia
10. Some Cancer Risks Higher in 9/11 Recovery Workers: Study
11. Chronic worriers at higher risk for PTSD
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/6/2016)... ... February 06, 2016 , ... ... MEDIA ADVISORY: 5000 PERIOPERATIVE NURSES EXPECTED AT AORN SURGICAL CONFERENCE & EXPO ... in the world with an estimated 5000 perioperative nurses in attendance to ...
(Date:2/5/2016)... ... February 05, 2016 , ... Steven Tonkinson, 36, of ... completed every year since it started in 2003. This year, he ran all 26.2 ... fellow runners and NBA team the Miami Heat. , This Sunday, while many are ...
(Date:2/5/2016)... ... February 05, 2016 , ... The event is being held ... Event Center in Minneapolis, Minn. Triumph Over Parkinson’s will fund nearly $100,000 for research ... Schneiderman’s Furniture, lives with Parkinson’s disease and is the architect of this informative event ...
(Date:2/5/2016)... ... February 05, 2016 , ... After years as an active staff surgeon ... and cosmetic surgeon Dr. Wayne Carman transitioned to chief of the Division of Plastic ... first three-year term as chief and began a second three-year term in January of ...
(Date:2/5/2016)... York, New York (PRWEB) , ... February 05, 2016 , ... ... gym use and find themselves having to wait longer to access the treadmills. It’s ... their New Year’s resolutions to lose weight and get in shape by joining gyms, ...
Breaking Medicine News(10 mins):
(Date:2/4/2016)... Medical, Inc. (Nasdaq: AEMD ), the pioneer ... diseases, today announced results for the third quarter ... --> --> "Beyond ... quarterly call, we strategically advanced pre-clinical and clinical ... the Aethlon Hemopurifier® as a leading broad-spectrum countermeasure ...
(Date:2/4/2016)... N.Y. , Feb. 4, 2016  AMRI (NASDAQ:  AMRI) ... President of Pfizer Inc. and President of Pfizer Global Supply, ... as of February 4, 2016. In addition, the Company announced ... of the audit committee since 2010, has retired from the ... and attention to his other business ventures.  ...
(Date:2/4/2016)... PUNE, India , February 4, 2016 ... to the new Market Research Report "North American Automated ... and Fully-Automated External Defibrillators), by End-User (Public Facilities, Hospitals, ... North American automated external defibrillators (AED) report defines and ... of the revenue. This market is estimated to grow ...
Breaking Medicine Technology: