If you’re not looking to the stars — that is, the Star Ratings available for each Medicare Advantage and Prescription Drug plan offered by a carrier — to increase your sales, now’s a great time to start. A recent article from Avalere Health confirms what some Agents may have already been observing: Medicare Advantage Members gravitate to plans with higher star ratings, which typically means four or five stars.
The Medicare Program Star Ratings range from 5 stars to 1 star, from Excellent to Poor.
For the 2016 list of CMS’ plan rating criteria visit CMS’ website. The star ratings for all Medicare Advantage and Part D drug plans can accessed on the Medicare plan finder, which I wrote about last week.
According to Avalere, 60 percent of Medicare Advantage plan Members now belong to plans with four or more stars. There are some logical reasons for these results: Under the Affordable Care Act, plans rated with four or more stars receive Quality Bonus Payments (QBPs) from CMS. QBPs may vary from $65 to $105 per member per month (usually noted as PM/PM) in a county with an average plan bid of $900 PM/PM. Plans awarded QBPs may use these CMS incentives to enhance Part D benefits, fund extra benefits, reduce copays or, in some cases, reduce Part B or Part D premiums.
For 2012 – 2014, 3 and 3.5 star-rated plans received adjusted QBP payments under a CMS demonstration authority. Those plans now rated with 3.5 stars or lower will no longer reap the benefit of the QBP payments. Star Ratings reflect many categories of plan performance so it is expected that CMS’s star rating program will improve the overall excellence of Medcare Advantage plans.
Agents can enhance their sales presentations and bring critical information about a plan’s quality to their clients by reviewing Star Ratings and explaining in detail how the ratings reflect plan performance. Plans rated with 4 or more stars offer the agent an attractive sales advantage over lower rated plans.
Affiliated Agents who would like additional information on how to educate their clients and enhance sales with Star Rating information can call (800) 997 3017 or email me to schedule a short and informative briefing regarding Star rating use in the sales presentation.