Table 3: Distribution of 2024 Overall Star Ratings for For-profit and Non-profit MA-PDs
2024 Overall Rating
Count
For-Profit
% For-Profit
Weighted By Enrollment For-Profit
Count Non-Profit
% Non-Profit
Weighted By Enrollment Non-Profit
5 stars
25
6.41
8.07
6
3.87
3.37
4.5 stars
35
8.97
32.46
40
25.81
25.84
4 stars
82
21.03
32.54
41
26.45
46.64
3.5 stars
96
24.62
17.34
42
27.10
19.26
3 stars
106
27.18
7.84
22
14.19
4.47
2.5 stars
42
10.77
1.72
4
2.58
0.41
2 stars
4
1.03
0.03
0
0
0
Total Rated Contracts
340
155
Table 4: Distribution of 2024 Part D Ratings for For-profit and Non-profit PDPs
2024 Part D Rating
Count
For-Profit
% For-Profit
Weighted By Enrollment For-Profit
Count
Non-Profit
% Non-Profit
Weighted By Enrollment Non-Profit
5 stars
0
0
0
2
11.11
1.64
4.5 stars
0
0
0
4
22.22
22.96
4 stars
4
13.79
0.60
3
16.67
31.18
3.5 stars
7
24.14
33.19
3
16.67
11.63
3 stars
10
34.48
54.85
5
27.78
30.57
2.5 stars
3
10.34
8.81
0
0
0
2 stars
3
10.34
0.06
1
5.56
2.01
1.5 stars
2
6.90
2.49
0
0
0
Total Rated Contracts
29
18
Length of Time in Program and Performance
Generally, higher overall Star Ratings are associated with contracts that have more experience in the MA program. MA-PDs with 10 or more years in the program are more likely to have 4 or more stars compared to contracts with less than 5 years in the program. For PDPs, the relationship is similar in that PDPs with 10 or more years in the program do better in the Star Ratings relative to contracts with less than 5 years experience. There are only three PDPs that have at least 5 years but less than 10 years of experience and two of the three received 4 or more stars. The tables below show the distribution of ratings by the number of years in the program (MA-PDs are shown in Table 5 and PDPs in Table 6 after adjustments for extreme and uncontrollable circumstances). [10]
Table 5: Distribution of 2024 Overall Star Ratings by Length of Time in Program for MA-PDs
2024 Overall Rating
Number of Contracts with less than 5 Years
% Less than 5 Years
Number of Contracts with 5 years to Less than 10 Years
% 5 Years to Less than 10 Years
Number of Contracts with 10 or More Years
% 10 or More Years
5 stars
6
3.53
3
2.86
22
8.15
4.5 stars
16
9.41
11
10.48
48
17.78
4 stars
24
14.12
27
25.71
72
26.67
3.5 stars
43
25.29
28
26.67
67
24.81
3 stars
50
29.41
31
29.52
47
17.41
2.5 stars
28
16.47
4
3.81
14
5.19
2 stars
3
1.76
1
0.95
0
0
Total Rated Contracts
170
105
270
Table 6: Distribution of 2024 Part D Ratings by Length of Time in Program for PDPs
2024 Part D Rating
Number of Contracts with less than 5 Years
% Less than 5 Years
Number of Contracts with 5 years to Less than 10 Years
% 5 Years to Less than 10 Years
Number of Contracts with 10 or More Years
% 10 or More Years
5 stars
0
0
1
33.33
1
2.38
4.5 stars
0
0
0
0
4
9.52
4 stars
0
0
1
33.33
6
14.29
3.5 stars
1
33.33
0
0
9
21.43
3 stars
0
0
0
0
16
38.10
2.5 stars
0
0
0
0
3
7.14
2 stars
0
0
1
33.33
3
7.14
1.5 stars
2
66.67
0
0
0
0
Total Rated Contracts
3
3
42
Average Star Rating for Each Measure
Below we list the average Star Ratings for 2021, 2022, 2023, and 2024 Part C and D measures (Tables 7, 8, and 9) using all measure scores for contracts that are publicly reported in a given year. All Star Ratings referenced in Tables 7, 8, and 9 are after adjustments for extreme and uncontrollable circumstances triggered by the COVID-19 public health emergency (PHE) for the 2022 Star Ratings for non-Health Outcomes Survey (HOS) measures and for the 2023 Star Ratings for HOS measures, and after adjustments for other qualifying extreme and uncontrollable circumstances [10] for the 2022 performance period have been applied.
Table 7: 2021 – 2024 Average Star Rating by Part C Measure
Measure
2021 Average Star
2022 Average Star
2023 Average Star
2024 Average Star
Breast Cancer Screening
3.5
3.9
3.7
3.7
Colorectal Cancer Screening
3.9
3.9
3.8
3.7
Annual Flu Vaccine
3.2
3.4
3.2
3.1
Monitoring Physical Activity
3.5
3.1
3.2
3.0
Special Needs Plan (SNP) Care Management
3.4
3.6
3.3
3.4
Care for Older Adults – Medication Review
4.3
4.4
4.4
3.8
Care for Older Adults – Pain Assessment
4.5
4.4
4.3
3.9
Osteoporosis Management in Women who had a Fracture
3.1
3.1
2.6
2.6
Diabetes Care – Eye Exam
3.8
3.8
3.7
3.5
Diabetes Care – Blood Sugar Controlled
4.2
4.3
4.1
3.6
Controlling Blood Pressure
NA
NA
3.5
3.4
Reducing the Risk of Falling
3.0
2.5
2.9
2.9
Improving Bladder Control
3.2
2.7
3.3
3.2
Medication Reconciliation Post-Discharge
3.0
3.5
3.4
3.4
Plan All-Cause Readmissions
NA
NA
NA
2.9
Statin Therapy for Patients with Cardiovascular Disease
3.1
3.5
3.5
3.3
Transitions of Care
NA
NA
NA
2.5
Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions
NA
NA
NA
3.0
Getting Needed Care
3.3
3.6
3.4
3.4
Getting Appointments and Care Quickly
3.4
3.6
3.5
3.5
Customer Service
3.5
3.8
3.4
3.6
Rating of Health Care Quality
3.3
3.6
3.4
3.3
Rating of Health Plan
3.2
3.5
3.2
3.1
Care Coordination
3.4
3.7
3.5
3.6
Complaints about the Plan
4.8
4.7
4.3
3.9
Members Choosing to Leave the Plan
4.0
4.1
3.5
3.6
Health Plan Quality Improvement
3.2
3.7
2.6
3.0
Plan Makes Timely Decisions about Appeals
4.3
4.6
4.6.
4.1
Reviewing Appeals Decisions
4.5
4.6
4.4
3.6
Call Center – Foreign Language Interpreter and TTY Availability
4.3
4.6
4.3
4.3
Table 8: 2021 – 2024 Average Star Rating by Part D Measure for MA-PDs
Measure
2021 MA-PD Average Star
2022 MA-PD Average Star
2023 MA-PD Average Star
2024 MA-PD Average Star
Call Center – Foreign Language Interpreter and TTY Availability
4.4
4.5
4.4
3.7
Complaints about the Plan
4.8
4.7
4.3
3.9
Members Choosing to Leave the Plan
4.0
4.1
3.5
3.6
Drug Plan Quality Improvement
3.5
4.2
2.7
3.4
Rating of Drug Plan
3.0
3.4
3.2
3.2
Getting Needed Prescription Drugs
3.5
3.8
3.4
3.5
MPF Price Accuracy
4.9
4.0
4.2
3.6
Medication Adherence for Diabetes Medications
3.7
3.7
3.0
3.3
Medication Adherence for Hypertension (RAS antagonists)
3.2
3.9
3.4
3.4
Medication Adherence for Cholesterol (Statins)
3.3
3.6
3.1
3.2
MTM Program Completion Rate for CMR
3.7
4.0
3.9
3.5
Statin Use in Persons with Diabetes (SUPD)
3.1
3.4
3.1
2.7
Table 9: 2021 – 2024 Average Star Rating by Part D Measure for PDPs
Measure
2021 PDP Average Star
2022 PDP Average Star
2023 PDP Average Star
2024 PDP Average Star
Call Center – Foreign Language Interpreter and TTY Availability
4.2
4.2
4.1
3.0
Complaints about the Plan
4.9
4.8
4.4
3.9
Members Choosing to Leave the Plan
4.1
4.2
4.0
3.8
Drug Plan Quality Improvement
4.1
4.1
2.2
2.9
Rating of Drug Plan
3.5
3.8
3.3
3.4
Getting Needed Prescription Drugs
3.6
3.9
3.5
3.5
MPF Price Accuracy
4.9
3.3
3.5
3.6
Medication Adherence for Diabetes Medications
3.9
3.9
2.9
2.6
Medication Adherence for Hypertension (RAS antagonists)
3.1
3.5
2.7
2.6
Medication Adherence for Cholesterol (Statins)
3.6
3.6
3.1
3.0
MTM Program Completion Rate for CMR
3.6
3.7
3.1
3.2
Statin Use in Persons with Diabetes (SUPD)
3.0
3.3
2.9
2.4
APPENDIX
Table A1: MA-PD Contracts Receiving the 2024 High Performing Icon
Contract ID
Contract Name
Parent Organization
9/2023
Enrollment
5 Star Last Year
Includes SNP Plan Benefit Packages
H0154
VIVA HEALTH, INC.
Triton Health Systems, L.L.C.
54,211
Yes
Yes
H0169
UNITEDHEALTHCARE OF WISCONSIN, INC.
UnitedHealth Group, Inc.
90,554
No
Yes
H0292
HUMANA HEALTH PLAN OF OHIO, INC.
Humana Inc.
10,217
Yes
No
H0332
KS PLAN ADMINISTRATORS, LLC
UnitedHealth Group, Inc.
49,331
Yes
No
H0710
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.
UnitedHealth Group, Inc.
49,125
Yes
Yes
H1036
HUMANA MEDICAL PLAN, INC.
Humana Inc.
602,593
No
Yes
H1290
DEVOTED HEALTH PLAN OF FLORIDA, INC.
Devoted Health, Inc.
35,402
No
Yes
H1537
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.
UnitedHealth Group, Inc.
8,965
Yes
No
H1961
PEOPLES HEALTH, INC.
UnitedHealth Group, Inc.
97,472
Yes
Yes
H1994
SELECTHEALTH, INC.
Intermountain Health Care, Inc.
47,705
Yes
Yes
H2292
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.
UnitedHealth Group, Inc.
9,608
Yes
Yes
H2610
ESSENCE HEALTHCARE, INC.
Lumeris Group Holdings Corporation
55,027
Yes
No
H2697
DEVOTED HEALTH PLAN OF OHIO, INC.
Devoted Health, Inc.
22,137
Yes
Yes
H3344
INDEPENDENT HEALTH BENEFITS CORPORATION
Independent Health Association, Inc.
4,943
Yes
No
H3362
INDEPENDENT HEALTH ASSOCIATION, INC.
Independent Health Association, Inc.
61,341
Yes
Yes
H3664
AULTCARE HEALTH INSURING CORPORATION
Aultman Health Foundation
14,078
Yes
No
H3907
UPMC HEALTH PLAN, INC.
UPMC Health System
148,511
Yes
No
H3957
HIGHMARK CHOICE COMPANY
Highmark Health
58,410
Yes
No
H4172
NHC ADVANTAGE, LLC
Missouri Healthcare Advisors, LLC
1,200
No
Yes
H4286
LEON HEALTH, INC.
Leon Health Holdings, LLC
39,137
No
Yes
H4461
CARITEN HEALTH PLAN INC.
Humana Inc.
166,542
Yes
Yes
H5215
NETWORK HEALTH INSURANCE CORPORATION
Network Health, Inc.
69,727
Yes
Yes
H5420
Preferred Care Network, Inc.
UnitedHealth Group, Inc.
39,879
No
Yes
H5471
SIMPLY HEALTHCARE PLANS, INC.
Elevance Health, Inc.
60,723
No
Yes
H5533
UPMC HEALTH NETWORK, INC.
UPMC Health System
18,950
Yes
No
H5577
MCS ADVANTAGE, INC.
MHH Healthcare, L.P.
207,906
No
Yes
H5594
OPTIMUM HEALTHCARE, INC.
Elevance Health, Inc.
59,431
Yes
Yes
H5652
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.
UnitedHealth Group, Inc.
6,007
Yes
Yes
H7617
EMPHESYS INSURANCE COMPANY
Humana Inc.
10,662
No
No
H9153
WEST VIRGINIA SENIOR ADVANTAGE, INC.
SNP Holdings, LLC
852
No
Yes
H9834
QUARTZ HEALTH PLAN MN CORPORATION
University of Wisconsin Hospitals and Clincs Autho
3,598
Yes
No
Table A2: 1876 Cost Contracts Receiving the 2024 High Performing Icon*
Contract ID
Contract Name
Parent Organization
9/2023
Enrollment
5 Star Last Year
H1651
MEDICAL ASSOCIATES HEALTH PLAN, INC.
Medical Associates Clinic, P.C.
15,046
Yes
H5256
MEDICAL ASSOCIATES CLINIC HEALTH PLAN
Medical Associates Clinic, P.C.
3,728
Yes
H5264
DEAN HEALTH PLAN, INC.
Medica Holding Company
13,409
Yes
*1876 Cost Contracts do not offer SNPs
Table A3: PDP Contracts Receiving the 2024 High Performing Icon
Contract ID
Contract Name
Parent Organization
9/2023
Enrollment
5 Star Last Year
S1822
HEALTHPARTNERS, INC.
HealthPartners, Inc.
2,404
No
S4501
INDEPENDENT HEALTH BENEFITS CORPORATION
Independent Health Association, Inc.
7,268
Yes
Table A4: Contracts Receiving the Low Performing Icon for the 2024 Star Ratings
Contract ID
Contract Name
Parent Organization
Reason for Low Performance Warning
9/2023 Enrollment
H0724
BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.
Centene Corporation
Part C or D
1,900
H5199
WELLCARE HEALTH INSURANCE OF ARIZONA, INC.
Centene Corporation
Part C
9,808
H6446
SILVERSUMMIT HEALTHPLAN, INC.
Centene Corporation
Part C or D
3,343
H7175
WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.
Centene Corporation
Part C
9.062
H7330
ZING HEALTH, INC.
Zing Health Consolidator, Inc
Part D
2,215
S6946
CLEAR SPRING HEALTH INSURANCE COMPANY
Group 1001
Part D
454,820
