Medicare Advantage plans to receive quality based bonuses

The Centers for Medicare & Medicaid Services is rating its Advantage plans on a five-star scale, with five stars representing the highest quality.  According to a report by Kaiser Family Foundation, beginning in 2010, plans with a rating of four stars or more will qualify to receive Medicare bonuses in 2012.

Key findings from the report:

  • 24 percent of beneficiaries are currently enrolled in plans with four or more stars, while 46 percent are in enrolled in plans rated with three stars or less.
  • Private Medicare Advantage plans with high quality ratings are concentrated in certain states, leaving beneficiaries in some states with few if any options for choosing a highly-rated plan.

The authors recommend that a careful review of the current rating system is warranted to ensure that the ratings are a valid and meaningful measure of a plan’s quality, particularly now that the quality ratings will be used for payment purposes.

(Sources: Kaiser Daily Health Policy Project, http://kaiserhealthnews.org, September 10, 2010; The Kaiser Family Foundation, Quality Ratings of Medicare Advantage Plans, http://www.kff.org/medicare/upload/8097.pdf, Septbember 2010)