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50-State Look At Medicare Advantage Plan Quality Rating Reveals Significant Variation in Beneficiary Enrollment Contact: Lindsey Spindle, 202.207.1337,
lspindle@avalerehealth.net Washington, DC – According to a new analysis released by Avalere Health, the percentage of Medicare Advantage beneficiaries enrolled in higher-quality plans, as rated by the government, varies widely by state, and in several states a majority of beneficiaries are in plans that received 2.5 or fewer stars in 2010. Last month Avalere analyzed the CMS 2010 Part C Report Card, released in November 2009, and enrollment data released in April 2010 to see whether beneficiaries’ plan selections correspond with quality ratings assigned by the government. Avalere replicated that analysis on a state-by-state level for all 50 states, revealing significant differences in enrollment by geography. 60 percent of beneficiaries in Georgia and 86 percent of beneficiaries in Nevada are in plans rated ‘2’ or ‘2.5’. 88 percent of Florida beneficiaries are in plans rated ‘2’ or ‘3’. Maine has the largest percentage of beneficiaries enrolled in 5-star plans, with 30 percent of all beneficiaries in the state enrolled. In Massachusetts, 69 percent of beneficiaries – all those whose plans have been rated – are enrolled in plans rated ‘4’ or ‘4.5’. In some states, a majority of beneficiaries are in plans with the same rating; in others, enrollment is more evenly distributed across ratings. 62 percent of beneficiaries in Minnesota are in plans rated ‘4’ or ‘4.5,’ while beneficiaries in Colorado are largely split among plans rated ‘3’ to ‘4.5.’ Importantly, not all beneficiaries have access to higher-quality plans. Top-rated, or 5-star, plans are available in just three states: Maine, Texas, and Florida. Plans may be offered only in certain counties, meaning that even if a beneficiary lives in a state where a top-rated plan is available, he or she may not be able to enroll. “As the government implements the new health reform provision tying Medicare Advantage plan funding to quality ratings, it will be important to determine whether the already significant regional variation in plan quality ratings will intensify,” said Bonnie Washington, a vice president at Avalere Health. April 2010 Percent of Medicare Beneficiaries Enrolled in Medicare Advantage Plans by Star Rating
If you have questions about your own plan selection or its star rating, please seek information from the plan or from the Centers for Medicare and Medicaid Services. Avalere does not offer consumer advice on plan selection and regretfully cannot help individuals with their plan inquiries. Avalere Health is an advisory services company whose core purpose is to create innovative solutions to complex healthcare problems. Based in Washington DC, the firm delivers research, analysis, insight, and strategy for leaders in healthcare business and policy. Avalere's experts span 125 staff drawn from the federal government (e.g., CMS, OMB, CBO, and the Congress), Fortune 500 healthcare companies, top consultancies, and nonprofits. The firm offers deep substance in areas ranging from healthcare coverage and financing to the changing role of evidence in healthcare decision-making. Its focus on strategy is supported by a rigorous, in-house analytic research group that uses public and private data to generate quantitative insight. Through events, publications, and interactive programs, Avalere also translates real-time healthcare developments into actionable information. Learn more at www.avalerehealth.net. Return to the News Room.
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