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