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40% of Medicare drug plans in FL rated below average

Nearly 40 percent of Medicare drug plans currently on the market in Florida received federal quality ratings of below average. That indicates Floridians' choices don't compare well to those nationwide.

On a five-star scale, 13 of Florida's 33 standalone drug plans offered under Medicare Part D earned less than three stars, the online rankings show. The rate nationwide of below-average plans is about 28 percent, Kaiser Health News reported.

“If there's a rating from one-to-five stars, then five stars is the place I would want to be," said Lee Millman, spokeswoman at the Centers for Medicare and Medicaid Services.

The glossary at the Medicare web site, www.medicare.govoffers the following definitions of the star system in terms of quality: 1 is "poor," 2 means "below average," 3 means "average," 4 means "above average" and 5 means "excellent."

There are no five-star drug plans on the market in Florida. Among the four-star plans are several sponsored by Blue Cross and Blue Shield of Florida.

(Florida has no five-star Medicare Advantage plans either, Health News Florida reported earlier this month. Medicare Advantage plans replace traditional Medicare, covering doctor visits and hospital care; many of them include drug coverage.)

Among the standalone drug plans with weak showings were Cigna Medicare RX, Aetna Medicare and Envision RX plus. The lowest-rated plan, at two stars, came from Unicare.

For most Medicare beneficiaries, the ratings are an afterthought at best, said Andrea Gary, who helps enroll Medicare patients through Florida SHINE, a government-sponsored help program for seniors mostly staffed with volunteers.

The star ratings have been in place since 2007, and underwent changes this year because of the federal health-care overhaul and proposals from CMS, said Jennifer Rak, senior manager at Avelere Health, a health-care consulting company.

The ratings take dozens of factors into account, including customer service, access to drugs and the management of chronic conditions.

Also in limbo is a proposal that would make it so plans that earn less than three stars over three consecutive years can lose their contracts with CMS, she said.

According to the Harris Foundation, a non-profit that looks at health issues, 98 percent of beneficiaries don't know how their plan is rated.

But that may change soon, said Rak, of Avelere.

As the government makes plan quality a higher priority, patients might, too, she said.

“Beneficiaries have historically selected plans based on premiums,” she said. “There's an effort to make sure that the plans the beneficiaries are choosing have some level of quality.”

---Health News Florida is an independent online publication dedicated to public-service journalism. Reporter Brittany Alana Davis can be reached at 954-239-8968 or by e-mail.