Medicaid Managed Care

News Briefs: Share of Highly Rated MA-PD Plans Will Drop in 2023

On Oct. 7, CMS released the 2023 Medicare Advantage Star Ratings, revealing that 51.3% of Medicare Advantage Prescription Drug (MA-PD) plan contracts will be rated 4 stars and above next year. That’s down from 68.4% of 2022 MA-PD contracts, Citi analyst Jason Cassorla observed in a note to investors. On an enrollment basis, 72.1% of current MA-PD enrollees are in plans rated 4 stars and above for 2023, down from 89.7% in 2022. “The lower MA Star Ratings for 2023 on a [year-over-year] basis are largely a function of CMS removing many of the COVID-19-related guardrails and relaxed criteria that aided Stars performance for 2021-2022,” Cassorla pointed out. “Ratings for 2023 were also impacted by changes to how plans are rated with CMS a greater emphasis on the Consumer Assessment of Healthcare Providers and Systems survey.”

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© 2024 MMIT

Medicaid MCOs Will Aid Ambitious New Waiver Demos in Massachusetts, Oregon

Recently, the Biden administration approved a pair of wide-ranging Medicaid waiver demonstration programs in Massachusetts and Oregon, granting those states authority to test unique policies such as keeping certain populations enrolled in Medicaid for more than a year and covering clinically tailored housing and nutritional supports. Medicaid managed care plans that serve Massachusetts and Oregon tell AIS Health that they’re planning to play a major role in helping to implement the new waiver programs, which will allow them to expand some of the social-needs-based interventions that they’re already providing and reduce the enrollee churn that can stymie care-management efforts.

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© 2024 MMIT