Community plans exceed the industry on Star ratings, despite overall industry declines
Washington, D.C. (October 18, 2024) – Alliance of Community Health Plans (ACHP) member companies offering Medicare Advantage (MA) plans perform better on 31 out of 42 performance measures relative to non-ACHP members, according to recently released Star Ratings. Specifically, ACHP members lead the industry on critical health measures and overall consumer satisfaction. MA is the only government health care program that measures and rewards high-quality, efficient, coordinated coverage and care, and community health plans consistently offer this high level of care to consumers.
“Even when Star ratings decline across the board, nonprofit, community-based, provider-aligned health plans have a unique advantage,” said ACHP President and CEO Ceci Connolly. “They are laser-focused on ensuring their members have access to high-quality coverage and care, which is borne out in this year’s ratings. Once again, ACHP members lead the industry in quality measures directly linked to clinical outcomes and consumer experience.”
More than 15 percent of all MA enrollees in a 4-Star plan or above are covered by an ACHP member plan, despite ACHP plans claiming only 10 percent of all MA enrollees overall. Importantly, this illustrates how significantly ACHP members outperform their non-ACHP competitors in providing quality coverage and care. Additionally, ACHP members provide coverage to nearly 24 percent of all MA enrollees in 4.5 Star contracts.
In total, nearly 18 percent of all MA plans receiving 4 stars and above from CMS were offered by an ACHP member company. Community plans receiving 4-Star and above ratings include: Aspirus Health Plan; AultCare Health Plans; Baylor Scott & White Health Plan; Capital District Physicians’ Health Plan (CDPHP); CommunityCare; Fallon Health; Geisinger Health Plan; HAP; Health Alliance; HealthPartners; Independent Health; Kaiser Foundation Health Plan; Martin’s Point Health Care; Priority Health; Providence Health Plan; Sanford Health Plan; Security Health Plan; Select Health; Sentara Health Plans; UCare; and UPMC Health Plan. Two Prescription Drug Plans receiving a 5-Star rating were also offered by an ACHP member company: Independent Health and UPMC Health Plan.
In addition to leading on overall scores, ACHP member companies excelled in key metrics—both in clinical measures and consumer experience. On average, ACHP member plans outscored non-ACHP plans on key measures, including preventive health care measures, member experience and drug safety and pricing accuracy.
“Medicare Advantage continues to grow and ACHP and our members will continue promoting the commonsense policy recommendations in MA for Tomorrow, our vision for the future of the program, which takes MA from good to great for generations to come,” said Connolly.
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About ACHP
The Alliance of Community Health Plans (ACHP) represents the nation’s top-performing nonprofit health companies, which serve tens of millions of Americans across nearly 40 states and D.C. ACHP member plans collaborate with providers on high-quality coverage and care — leading the industry in practical reforms, including MA for Tomorrow, our vision for the future of Medicare Advantage.
ACHP is the voice of a unique payer-provider partnership model advancing proven solutions that deliver better value for patients, employers and taxpayers. Contact us for case studies and data about member innovations and results.
