About a quarter of 47 million people in Medicare are enrolled in Medicare Advantage plans, which are offered by insurance companies as alternatives to the traditional program. The plans often include prescription drug coverage and federal officials began rating these plans a few years back using a scale of one to five stars. But according to some of the seniors' advocates, policy analysts, insurers and some top Medicare officials, the ratings are defective.
Bonuses will be awarded worth hundreds of millions of dollars to the best plans on the basis of ratings, under the new healthcare overhaul law.
Brian Biles, a Health Policy Professor at George Washington University, shared that the top-rated plans would have received a total of $1.3 billion, if the bonuses had been in operation last year.
Jonathan Blum, Deputy Administrator for the Centers for Medicare and Medicaid Services, opines that beneficiaries prefer to pick Medicare Advantage plans based on cost and access to their doctors, not ratings. Plans with three or fewer stars are chosen by more than 75% of the plans' members.
Only 5% of Medicare Advantage members in Virginia are in four-star plans found Avalere Health, a consulting firm, as compared to 33% in Maryland and 68% in the district. Since none of the plans offered here has earned the top grade, nobody in Washington area is enrolled in a five-star plan.