Most FL Plans Shine in Star Ratings

Oct 28, 2014

Just a handful of Florida Medicare Advantage plans offered for 2015 received below average scores in a federal quality rating system, a breakdown of data by Avalere Health shows.

Not a single one of the 125 plans offered by 24 different insurers earned the poorest rating for 2015, according to the data released this month by the Centers for Medicare and Medicaid Services. For a detailed list, click here.

Credit .S. Department of Health and Human Services

The lowest score came from Florida Healthcare Plus, which already is under state and federal suspension and is unable to enroll new members. All four plans offered by the Coral Gables company -- Sunrise, Sunny Days, Clear Skies and Day Break -- earned a below-average score.

The plans scored poorly in dozens of categories, like failure to properly manage chronic conditions, provide enough preventative health measures such as flu shots, or adequately handle member complaints. Medicare Advantage plans offering prescription drug coverage also are judged on criteria such as customer service, drug safety and accurate pricing.

Three plans from UnitedHealthcare earned an average rating: AARP Medicare Complete, the AARP Medicare Complete Choice and the Dual Complete plan. The plans are offered in 15 Florida counties, mostly in the Tampa Bay region, Central Florida and the Treasure Coast.

United HealthCare spokeswoman Jessica Pappas said the company offers a variety of plans, and tries to make improvements in its star ratings every year.

“UnitedHealthcare continues to strive to make year-over-year improvement in our quality performance and in the health care experience for millions of Medicare beneficiaries,” she said in a written statement.

CMS created the Star Rating system as a way to track plan quality, on a scale of one to five. This year, just 16 plans in the nation earned the prestigious five-star rating, including Humana’s CarePlus Health Plans Inc. in Florida.

Avalere’s national analysis of the ratings noted that the number of Medicare beneficiaries who choose top-performing plans continues to increase, especially in the prescription-drug plans. In 2015, about 40 percent of the nation’s Medicare Advantage plans that also offered drug coverage earned four stars or better. Those contracts cover approximately 60 percent of all plan enrollees, the analysis said.

The managed care plans are a popular option for many seniors looking to get the most coverage for their money. Florida’s market is so competitive that a bevy of plans charge no monthly premium beyond the $104.90-a-month monthly premium for Medicare Part B, which is usually withheld from beneficiaries' Social Security checks. In Florida, some plans even pay part or all of the Part B premium.

But consumer demand isn’t the only reason why plans are improving, according to Avalere. CMS offers financial bonuses to plans earning four or five stars, and those earning  top scores can enroll members year-round. That’s an enormous boost considering open enrollment runs just Oct. 15 to Dec. 7.

The incentives have a direct impact on the quality of Medicare plans, Avalere Chief Executive Dan Mendelson and his analysts wrote. The better performers tend to be older, more-established programs.

“The Affordable Care Act put in place strong financial incentives to improve quality, and health plans are responding with improvements that are exceeding most expectations,” Mendelson said.

--Health News Florida is part of WUSF Public Media. Contact Editor Mary Shedden at (813) 974-8636, on Twitter @MaryShedden, or email at shedden@wusf.org. For more health news, visit HealthNewsFlorida.org.