New Medicare Advantage plan analysis from JAMA (Video)

Rachel O. Reid, M.S., of the Centers for Medicare & Medicaid Services, Baltimore, and colleagues conducted a study to assess the association between publicly reported Medicare Advantage plan quality ratings and enrollment that was reported in the Jan. 15, 2013, issue of the Journal of the American Medical Association (JAMA).

The study population consisted of 952,352 first-time enrollees and 322,699 enrollees switching plans. The analysis controlled for beneficiary and plan characteristics.

To inform enrollment decisions and spur improvement in the Medicare Advantage marketplace, the U. S. Centers for Medicare & Medicaid Services (CMS) provides star ratings reflecting Medicare Advantage plan quality. A combined Part C and D overall rating was created in 2011 for Medicare Advantage and prescription drug (MAPD) plans," according to background information in the article. The star ratings incorporate data from several sources. "In 2011, MAPD star ratings ranged from 2.5 to 5 stars. Only 3 MAPD contracts received 5 stars; some were unrated because they were too new or small," the authors write. "While star ratings clearly matter to insurers, it is unclear whether they matter to beneficiaries."

Centers for Medicare and Medicaid Services - Medicare & You 2010, official government handbook

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http://www.medicare.gov This work is in the public domain in the United States because it is a work prepared by an officer or employee of the United States Government

Among the key characteristics of included plans by star rating, the highest-rated plans more often had higher premiums, while unrated plans more often had higher out-of-pocket costs or were private fee-for-service or local PPO plans.

The researchers found that among first-time enrollees, higher star ratings were associated with increased likelihood to enroll in a given plan (9.5 percentage points per 1-star increase). The highest rating available to a beneficiary was associated with a 1.9 percentage-point increase in likelihood to enroll. Star ratings were less strongly associated with enrollment for the youngest, black, low-income, rural, and Midwestern enrollees

In Alabama, Health Spring and Humana offer the lowest cost highest coverage of all Medicare Advantage plans in the majority of counties.

All Medicare plans costs are scheduled to increase costs and decrease coverage in 2013.

The research was reviewed at the Eureka Alert website the date of publication.