Elevance Health's Medicare Advantage Performance Declines, Company Reveals Plans to Improve
Elevance Health's affiliated health plans have seen a significant drop in their Medicare Advantage Star Ratings, with the percentage of members in 4-star or higher-rated plans expected to decline to approximately 34% as of 2024, compared to 64% in 2023. This decline is primarily driven by three large contracts, which will decrease from 4 or 4.5 stars to 3.5 stars. The decrease in Star quality bonus payments and plan level rebates is expected to impact the company in 2025.
Key Takeaways:
- Elevance Health's affiliated health plans have seen a significant decline in their Medicare Advantage Star Ratings, with a drop from 64% in 4-star or higher-rated plans in 2023 to approximately 34% in 2024.
- The decline is primarily driven by three large contracts, which will decrease from 4 or 4.5 stars to 3.5 stars.
- The decrease in Star quality bonus payments and plan level rebates is expected to impact the company in 2025.
- Elevance Health has introduced an innovative customer service model and enhanced core and supplemental benefits to improve its performance in future periods.
- The company has improved its performance in more than half of the 40 metrics measured by CMS, reflecting its commitment to providing high-quality healthcare solutions.
- All Elevance Health affiliated Medicare Advantage plans in Florida received a rating of at least 4.5 stars, with two plans receiving a perfect 5-star rating.
- Elevance Health has committed to providing high-quality Medicare Advantage plans that address the whole health needs of its members and achieving its long-term goal of offering top-performing health plans in each of its markets.
Statistics:
- 64%: Percentage of Elevance Health affiliated health plans in 4-star or higher-rated plans as of 2023
- 34%: Expected percentage of members in 4-star or higher-rated plans as of 2024
- 36%: Percentage of Medicare Advantage members represented by the three large contracts that will decline from 4 or 4.5 stars to 3.5 stars
- 40: Number of metrics measured by CMS
- 20: Number of metrics improved by Elevance Health
Sources:
- U.S. Securities and Exchange Commission
- Centers for Medicare & Medicaid Services (CMS)
- Medicare Advantage Star Ratings report
- Elevance Health's Form 8-K (Current Report) filed with the U.S. Securities and Exchange Commission on October 13, 2023
- Elevance Health's press release dated October 13, 2023