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14 Medicare Advantage Plans Earn 5 Stars

Margaret Dick Tocknell, for HealthLeaders Media, October 30, 2013

This year, CMS awarded five-star quality ratings to 14 Medicare Advantage plans covering about 5.6 million enrollees. Among the significant perks of being a five-star plan: the ability to enroll members throughout the year rather than only during the seven-week Medicare open enrollment period. That means five-star health plans "are always open for [new] business," says Matthew Eyles, executive vice president of Avalere Health, a healthcare consulting group.

He explains that for many health plans the Medicare Advantage premiums collected tend to be higher than what they command in the commercial marketplace, so being able to market and enroll members throughout the year is attractive.

This year's 5-star plans:

  • Kaiser Foundation Health Plans; CA, CO, GA, HI, OR, WA and the Mid-Atlantic states
  • KS Plan Administrators; TX
  • Group Health Cooperative; WA
  • Gunderson Health Plan; IA, WI
  • HealthSpring of Florida
  • Providence Health Plan; OR and WA
  • Medical Associates Health Plan; IA, IL
  • Dean Health Plan; WI

One thing I noticed is the lack of for-profit national players among this elite group. Although these big players are willing and able to throw resources at the star rating program, it is simply not that easy to become a five-star plan, explains Eyles.

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