Major insurers expect impact from lowered Medicare star ratings
Humana and Cigna may take a financial hit thanks to unfavorable results in the latest Medicare star ratings report released by CMS.
According to the Wall Street Journal, Humana felt its lower grade wasn’t fair. CMS data said Humana’s membership in Medicare Advantage or prescription drugs plans ranked four stars or higher for the 2018 plan year fell to about 37 percent, or 1.17 million members, from 78 percent, or 2.15 million members, last year.
Chris Rigg, an analyst with Susquehanna Financial Group, told the Journal the reduced quality ratings for Humana could create a “5 percent or greater reimbursement hole that needs to be backfilled” by changing plan designs.
Cigna could also be impacted financially from its result, which showed its four-star or higher membership share went from 67 percent to 20 percent. Like Humana, Cigna argued this wasn’t an accurate portrayal of the offerings.
For more on how both insurers plan to review the CMS ratings, click on the link below:
John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.