Medicare is trying to push seniors into higher-quality Medicare Advantage plans while also giving plans stronger incentives to improve.
Jonathan Blum, deputy administrator at the Centers for Medicare and Medicaid Services, described some of CMS' efforts Monday. Beginning next year, he said, Medicare Advantage plans with a five-star quality rating from CMS will be able to market their policies — and enroll new customers — all year. Lower-quality plans can only market during the annual open enrollment period.
In addition to helping high-quality plans boost their marketing, Blum said, CMS will begin using graphical warnings to identify consistently low-performing policies.
Blum reminded the crowd at an insurance industry conference that CMS has the authority to "terminate" low-quality plans, though it has never used that power.
CMS is also changing the way it decides which policies deserve a five-star rating. The agency will soon begin giving more weight to metrics that measure outcomes and patient satisfaction. Blum said the changes will help more Medicare Advantage plans gain higher ratings from CMS.
“When we weight more by outcomes … more plans are deemed to be five-star,” Blum said at a conference sponsored by America's Health Insurance Plans.