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Topic: Star Ratings
Times Are A-Changin’…Get Your Team to the GHG Forum June 12-13
In response to client requests, GHG is holding its first-ever Client Forum June 12-13 in Washington. With so much change in the air in government programs, the Forum is the perfect opportunity to get your team focused on the road ahead.
I don’t often pick fits with the GAO…But when I do, I prefer it’s about Medicare Advantage
The non-partisan GAO doesn’t much like the demonstration plan that accelerated the MA Quality based payment initiative, known as the Star Rating System. You can read why here, here, or here. For my colleague John Gorman’s great summary, visit us over here.
GAO Says Stars Bonus Demo is an $8 Billion Waste
The Government Accountability Office released a report yesterday recommending that CMS cancel the Star Ratings Bonus Demonstration, saying it would spend over $8 billion rewarding plans with only average quality improvement. That $8.3 billion — to be awarded to plans with at least a 3-Star rating — would offset “a significant portion” of the MA payment cuts in the Affordable Care Act (ACA). Read more
Don’t waste your travel budget
We’re less than three months from the GHG Forum. This is NOT your usual conference. We’ve developed a unique educational retreat for management teams working in government programs. I’m thrilled at the presentations our faculty are preparing: we’re putting our senior consultants on the stage to deliver case studies, war stories and tales of best practices. But just as importantly, we’re building in time for you to react to these sessions with your team— to develop questions for your track faculty, compare notes, discuss implementing the best practices you’ve learned about.
More Good News for Medicare Advantage in 2013 Rate Announcement
CMS released the 45-Day Notice of CY 2013 Medicare Advantage (MA) rates after the market close on Friday, and while it’s the usual hot mess of green-eyeshade factors that comprise payment, it brought unexpectedly positive news for the industry. If it holds up in the final rate announcement on April 2, it will represent the largest increase in payments to plans in 4 years. Here’s a brief rundown of what’s hot, what’s not, and what to watch in the runup to the final rates.
MA Enrollment – Good News
Today Secretary Sebelius announced the results of the annual election period showing that Medicare Advantage (MA) enrollment increased by 10 percent compared to this time last year. She declared that Medicare Advantage is “stronger than ever”. This is consistent with my prediction in a December 2, 2011 blog based on reports we were seeing on the ground and hearing from the industry. The best news is that more beneficiaries are enrolling in 4 and 5 star plans, suggesting that the star bonuses and better information to beneficiaries may be influencing the choices. It is interesting that enrollment in stand-alone Prescription Drug Plans increased while enrollment in Medicare Advantage plans with drug coverage (MA-PDs) declined compared to last year. Enrollment in Special Needs Plans also increased about 10 percent. I look forward to seeing research on the effects of the new quality incentives on beneficiary choices and future changes in star ratings and beneficiary satisfaction surveys.
Forbes Gets it Wrong on Medicare Advantage
Forbes recently published a blog post (“Seniors: No, You Cannot Keep Your Plan Even if You Like It”) that was wildly off the mark on the future of Medicare Advantage. I commented directly there (my handle on the Forbes blog is MedicareNinja), but had to call it out here.
