November 11, 2022
© 2022 – Don Gerdts. All rights reserved.
Abstract
Alliance of Community Health Plans (ACHP) member companies offering Medicare Advantage plans score better than other MA plans in CMS Star Ratings, both on critical health measures and overall satisfaction. More than 33% of all beneficiaries nationwide in 5-Star plans are enrolled with an ACHP member plan while ACHP members represent approximately 10% of total Medicare Advantage enrollees.
In total, nearly 1/3 (31.6 percent) of all 5-Star plans were offered by an ACHP member company. Community plans receiving 5-Star ratings include: Aultcare; Baylor Scott & White Health Plan; CDPHP; Dean Health Plan; HealthPartners; Independent Health; Kaiser Permanente; Martin’s Point Health Care; Priority Health; SelectHealth; and UPMC Health Plan.
In addition to leading on overall scores, ACHP member health plans excelled in key metrics—both in clinical measures and consumer experience. On average, ACHP member plans outscored the competition on 45 out of 50 measures, including managing chronic conditions, customer service and rating of health plan.
ACHP plans also scored high on consumer retention. More than half of all ACHP member companies report roughly 90 percent of enrollees stay with their MA plan year after year, outpacing the competition by more than 10 percent.
Overall, more than 60 percent of MA plans offered by ACHP member companies earned a 4.5 or higher Star rating from CMS.
Why do ACHP plans score better than other health plans?
ACHP President and CEO Ceci Connolly says, “These scores are a result of community health plans’ unique approach to coverage and care. When payers and providers work together, they’re able to focus on consumers’ needs—ensuring better health outcomes and an overall better care experience. As we look ahead to the future of Medicare Advantage, ACHP and our members are committed to improving and modernizing the program to further demonstrate the positive impact payer-provider systems have on health outcomes.”
Next Steps
What do you think? Is there performance magic in the structure and legal organization of a health plan? Are the missions of ACHP plans different or more altruistic than other plans? Share your thoughts in the comments below!
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