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Fact Sheet - 2014 Star RatingsStar Ratings are driving improvements in Medicare quality. This year there have been significant increases inthe number of Medicare beneficiaries in high-performing Medicare Advantage (MA) plans. The informationincluded in this Fact Sheet is based on the 2014 Star Ratings published on Medicare Plan Finder on October 8,2013. The Centers for Medicare & Medicaid Services (CMS) publishes the Star Ratings each year to assistbeneficiaries in finding the best plan for them and to determine Medicare Advantage Quality Bonus Payments.Moreover, they support the efforts of CMS to improve the level of accountability for the care provided byphysicians, hospitals, and other providers, including enrollees of Medicare Advantage and Prescription DrugPlans.2014 EnhancementsMedicare Advantage with prescription drug coverage (MA-PD) sponsors are rated on up to 48 quality andperformance measures, MA-only sponsors (without prescription drug coverage) are rated on up to 36 measures,while stand-alone PDP sponsors are rated on up to 15 measures. Measurement is done at the contract level.Each year, CMS conducts a comprehensive review of the measures that make up the Star Ratings, consideringthe reliability of the measures, clinical recommendations, feedback received from stakeholders, and data issues.Any measure removed from the Star Ratings is displayed on the informational page of www.cms.gov. Changesto existing measures are summarized in Attachment A.The Star Ratings measures span five broad categories: OutcomesIntermediate OutcomesPatient ExperienceAccessProcessFor 2014, outcome and intermediate outcome measures continue to be weighted three times as much as processmeasures, and patient experience and access measures are weighted 1.5 times as much as process measures.CMS assigns a weight of 1 to all new measures (there are no new measures for 2014). Last year the Part C andD quality improvement measures received a weight of 1, and this year the weights have been changed to 3 sincethey are no longer new measures. CMS continues to reduce the overall Star Rating for contracts with seriouscompliance issues, defined as the imposition of enrollment or marketing sanctions.Highlights of Contract Performance in 2014 Star RatingsChanges in Ratings from 2013The average Star Rating weighted by enrollment for MA-PDs is 3.84, compared to 3.66 in 2013, and 3.41 in2012. Approximately 38 percent of MA-PDs (162 contracts) that will be active in 2014 earned four stars orhigher for their 2014 overall rating.Weighted by enrollment, these contracts serve approximately 52 percent of enrollees as can be seen inTable 1 below.This is a nearly 14 percentage point increase from 38 percent of enrollees in contracts with four or morestars last year.1

Table 1: 2012 -2014 Overall Rating Distribution for MA-PD Contracts2012MA-PD Overall Rating5 stars4.5 stars4 stars3.5 stars3 stars2.5 stars2 starsTotal# .7314.771.361002013Weighted byEnrollment8.999.9010.0133.9628.857.960.32# 8.4113.420.451002014Weighted byEnrollment9.4215.8112.5636.4820.255.280.21# 5.293.710.23100Weighted byEnrollment9.5620.5521.6830.4916.631.090.01The average Star Rating weighted by enrollment for PDPs is 3.04 for 2014, compared to 3.30 in2013, and 2.92 in 2012. The average PDP Star Rating for 2014 reflects reductions in the ratings forcontracts under CMS enrollment sanctions. If this enrollment penalty was not applied, the averageStar Rating weighted by enrollment for PDPs would be 3.23 for 2014. Approximately 37 percent of PDPs (27 contracts) that will be active in 2014 received four ormore stars for their 2014 overall ratingWeighted by enrollment close to 9 percent of PDP enrollees are in contracts with four or morestars as seen in Table 2.This is a 9 percentage point decrease from 18 percent of PDP enrollees in contracts with 4 or more starslast year.Table 2: 2012 -2014 Part D Rating Distribution for PDPs2012Part D Rating5 stars4.5 stars4 stars3.5 stars3 stars2.5 stars2 stars1.5 starsTotal# 134.6901002013Weighted byEnrollment1.850.137.519.3957.7822.520.820# .861.4301002014Weighted byEnrollment1.853.5212.223.3555.083.230.770# 1.391.39100Weighted byEnrollment0.133.345.2952.3914.165.62019.075-Star Contracts19 contracts are highlighted on Medicare Plan Finder (MPF) with a high performing (gold star) icon; 11 areMA-PD contracts (Table 3), 3 are MA-only contracts (Table 4), and 5 are PDPs (Table 5).The seven new high performing icon contracts for this year are: National Rural Electric Cooperative Association (E2332)MoDOT/MSHP Medical and Life Insurance Plan (E4744)KS Plan Administrators, LLC (H0332)Kaiser Foundation HP OF GA, INC. (H1170)HealthSpring OF Florida (H5410)Providence Health Plan (H9047)Tufts Insurance Company (S0655)2

Table 3: MA-PD Contracts Receiving the 2014 High Performing 5262H5410H9003H9047Contract NameKS Plan Administrators, LLCKaiser Foundation HP, INC.Kaiser Foundation HP of COKaiser Foundation HP of GA, INC.Kaiser Foundation, INC.Kaiser FNDN HP of the Mid-Atlantics STSGroup Health CooperativeGundersen Health PlanHealthSpring of FloridaKaiser Foundation HP of the NWProvidence Health 8240813722435596970442395Non-EGHP Service Area255 counties in TX31 counties in CA17 counties in CO21 counties in GA3 counties in HID.C., 11 counties in MD, 9 counties in VA13 counties in WA5 counties in IA, 11 counties in WI67 counties in FL10 counties in OR, 5 counties in WA10 counties in OR, 1 county in WAEGHP Service Area251 counties in TXNot applicableNot applicable9 counties in GANot applicableNot applicableNot applicableNot applicable63 counties in FL1 county in OR, 1 county in WA2 counties in OR5 StarLast oNoNoYesNoNoTable 4: MA-only Contracts Receiving the 2014 High Performing IconContractIDH1651H5264H6052Contract NameMedical Associates Health Plan, INC.Dean Health Plan, INC.Kaiser Foundation HP, INC.Enrolled10/20139821214112073Non-EGHP Service Area6 counties in IA, 1 county in IL8 counties in WINot applicableEGHP Service AreaNot applicableNot applicableNot applicable5 Star LastYearYesYesYesSNPNoNoNoTable 5: PDP Contracts Receiving the 2014 High Performing IconContractIDE2332E4744S0655S3994S8841Contract NameNational Rural Electric Cooperative AssociationMoDOT/MSHP Medical and Life Insurance PlanTufts Insurance CompanyHawaii Medical Service Association (HMSA)Catamaran Insurance of Ohio, INC.Enrolled10/20138008585361788602Non-EGHP ServiceAreaNot applicableNot applicableNot applicableNot applicableNot applicableEGHP ServiceArea37 regions34 regions35 regions34 regions36 regions5 Star Last YearNoNoNoYesYesLow Performers39 contracts are identified on the MPF with the low performing icon (LPI) for consistently low quality ratings inthe past three years (i.e., 2.5 or fewer stars for the 2012, 2013 and 2014 Star Ratings for Part C and/or Part D). For the time period from 2012 through 2014, 4 of these contracts are receiving the icon for low Part Cratings of 2.5 or fewer stars, 25 are receiving it for low Part D ratings of 2.5 or fewer stars, 6 arereceiving it for low Part C or D ratings of 2.5 or fewer stars, and 4 are receiving it for low Part C and Dratings of 2.5 or fewer stars.14 of the 26 contracts receiving the LPI in 2013 either improved their ratings in 2013 or withdrew orconsolidated their contracts.Below is the list of contracts receiving an LPI (Table 6).Table 6: 2014 Contracts with a Low Performing Icon (LPI)Contract 43H3240H3327H4005H4006H4011H4012Contract NameCARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANYUNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.WELLCARE OF TEXAS, INC.UNITEDHEALTHCARE INSURANCE COMPANYUNITEDHEALTHCARE OF GEORGIA, INC.WELLCARE OF GEORGIA, INC.HARMONY HEALTH PLAN OF ILLINOIS, INC.UNITEDHEALTHCARE INSURANCE COMPANYWELLCARE OF LOUISIANA, INC.LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTYAMERIGROUP NEW JERSEY, INC.TOUCHSTONE HEALTH HMO, INC.TRIPLE-S SALUD, INC.MCS ADVANTAGE, INC.FIRST MEDICAL HEALTH PLAN, INC.TRIPLE-S SALUD, INC.Parent OrganizationUnitedHealth Group, Inc.UnitedHealth Group, Inc.WellCare Health Plans, Inc.UnitedHealth Group, Inc.UnitedHealth Group, Inc.WellCare Health Plans, Inc.WellCare Health Plans, Inc.UnitedHealth Group, Inc.WellCare Health Plans, Inc.Local Initiative Health Authority for LA CountyWellPoint, Inc.Touchstone Health Partnership, IncTriple-S Management CorporationMedical Card System, Inc.First Medical Health Plan, Inc.Triple-S Management CorporationReasonEnrolledfor LPI10/2013Part C or D24034Part D36034Part C or D3765Part D5419Part D8850Part C or D26997Part C and D3715Part D208Part D7837Part C or D6287Part C and D5596Part C13092Part D23141Part D54559Part C19875Part D27380Part es3

Contract 40S5907S5932S5960Contract NameHEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.BLUECROSS AND BLUESHIELD OF SOUTH CAROLINAUNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.UNITEDHEALTHCARE OF WISCONSIN, INC.SUPERIOR HEALTH PLAN, INC.THE PYRAMID LIFE INSURANCE COMPANYARCADIAN HEALTH PLAN, INC.VNS CHOICEBRIDGEWAY HEALTH SOLUTIONSWINDSOR HEALTH PLAN, INC.TRIPLE-S SALUD, INC.FIRST MEDICAL HEALTH PLAN, INC.AMERIGROUP MARYLAND, INC.CARESOURCEUNITEDHEALTHCARE COMMUNITY PLAN, INCUNITEDHEALTHCARE OF FLORIDA, INC.CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANYCARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.PHARMACY INSURANCE CORPORATION OF AMERICAFIRST MEDICAL HEALTH PLAN, INC.TRIPLE-S SALUD, INC.HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.UNICARE LIFE & HEALTH INSURANCE COMPANYParent OrganizationCIGNABlueCross BlueShield of South Carolina (BCBSSC)UnitedHealth Group, Inc.UnitedHealth Group, Inc.Centene CorporationUniversal American Corp.Humana Inc.Visiting Nurse Service of New YorkCentene CorporationMunich American Holding CorporationTriple-S Management CorporationFirst Medical Health Plan, Inc.WellPoint, Inc.CareSource Management Group Co.UnitedHealth Group, Inc.UnitedHealth Group, Inc.UnitedHealth Group, Inc.UnitedHealth Group, Inc.Pharmacy Insurance Corporation of AmericaFirst Medical Health Plan, Inc.Triple-S Management CorporationCIGNAWellPoint, Inc.ReasonEnrolledfor LPI10/2013Part C1168Part D12591Part D8351Part D1622Part D2628Part C and D3344Part C or D11404Part D13718Part C1181Part D59430Part D11411Part C and D8944Part D435Part D1209Part D5451Part C or D15486Part D55704Part D112024Part D7213Part D625Part D8181Part D457881Part D67748Part esYesNoYesYesYesYesNoYesYesNoNoNoNoNoTax Status and Performance Organizations that are non-profit tend to receive higher ratings than those that are for-profit. Nonprofit organizations also performed better than for-profit organizations last year.Below is the ratings distribution by tax status for MA-PD (Table 7) and PDP (Table 8) contracts.Table 7: Distribution of For-profit and Non-profit MA-PDsMA-PD Overall Rating5 stars4.5 stars4 stars3.5 stars3 stars2.5 stars2 starsTotal # contracts# of Contracts2316211994141323For Profit%Weighted by 1022.064.331.40.310.01100# of Contracts9332524152108Non-Profit%Weighted by .893.771.850.34100Table 8: Distribution of For-profit and Non-profit PDPsPart D Rating5 stars4.5 stars4 stars3.5 stars3 stars2.5 stars2 stars1.5 starsTotal# of Contracts226111271142For Profit%Weighted by 13.6216.675.842.3802.3819.99100# of Contracts341075130Non-Profit%Weighted by .623.30.95100Length of Time in Program and PerformanceOn average, higher Star Ratings are associated with more experience in the MA program. We do not see asimilar pattern for PDPs. The tables below show the distribution of ratings by the number of years in theprogram (MA-PDs in Table 9, and PDPs in Table 10).4