CMS Unveils 5-Star Medicare Advantage Plans

Officials at Martin's Point Health in Portland, ME learned Wednesday that its Medicare Advantage health plans scored two five-star ratings from the Centers for Medicare & Medicaid Services.

A five-star designation is a rarity; only 12 out of 446 plans rated achieved it in 2011. The rating means that Martin's Point's Value and Prime Medicare Advantage plans will qualify in 2012 for a cut of an estimated $3 billion in bonus payments. Also, the two plans will be able to enroll members throughout the year rather than only during the seven-week Medicare enrollment period.

The other Medicare Advantage plans with a five-star ratings for 2011 are Advocare in Wisconsin; Dean Health Plan in Wisconsin; Group Health Cooperative in Washington; Gunderson Lutheran Health Plan in Iowa and Wisconsin; Health New England in Massachusetts; and Kaiser Permanente in California, Colorado, Hawaii, Oregon and Washington.

Larry Henry, vice president of Medicare at Martin's Point, said the rating will provide a strategic advantage for the small plan, which has only 12,500 Medicare Advantage members. "Now we'll be able to tell our story and market our plans year-round. We'll be able to separate ourselves from the other Medicare Advantage health plans that can sell their products for only a short time each fall."

He said the plans were close last year –they were received 4.5 stars—and some tweaking helped kick them into star status. The plans posted important gains in preventive services thanks to a campaign to increase flu shots among its Medicare Advantage members.

The ratings program, created to help CMS monitor plan performance, has been around for four years, but it only began to generate real interest among health plans when the bonus payments were added as part of the Affordable Care Act.

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