CVS Health delivered on its claims that its Medicare Advantage star ratings would improve for 2024.
According to documents filed with the Securities and Exchange Commission on Oct. 13, 87 percent of Aetna's Medicare Advantage membership will be enrolled in contracts rated at four stars or higher by CMS in 2024, up from 21 percent in 2023.
Aetna's National PPO plan, which has more than 2 million members, was rated at four stars by CMS for 2024, up from 3.5 stars in 2023. Plans must receive star ratings of four or higher to be eligible for bonus payments from CMS.
CVS projected a revenue loss of $800 million to $1 billion in 2024 due to the lower star ratings in 2023. The company expects to recover most of these losses in 2025, according to the regulatory filing.
The percentage of Elevance Health members enrolled in contracts rated at four stars or higher declined from 64% in 2023 to 34% for 2024, the company reported in regulatory filings. Three of the company's largest MA contracts by enrollment will decline from 4.5 or four stars to 3.5 stars in 2024.
The company said it was "disappointed" with its performance on certain metrics, especially declines in member's reported satisfaction with access to appointments and care.
Elevance is "exploring all options" to mitigate revenue effects for 2025 from the decline in bonus payments, according to the filing.
Centene, another insurer that has struggled with star ratings, saw some improvements, moving 87% of its membership to contracts rated at three stars or higher, up from 53% in 2023, according to regulatory filings.
The company fell short of its previous target of moving 20% of its membership to plans rated at four stars or higher. Centene's only contract rated four stars or higher in 2023, SelectCare of Texas, declined to three stars in 2024, according to CMS data, leaving the payer with no bonus-eligible contracts.
In the regulatory filings, Centene said the star ratings are in line with comments its executives made in July, indicating it would improve the number of members in three- and 3.5-star contacts.
"While the company has work to do to improve star scores, this demonstrates the first step towards its multi-year goals," Centene said in the filing.