Insurers such as UnitedHealth Group and Anthem have been working hard to draw people to their Medicare Advantage plans by boosting quality of care and customer service—and as a result, star ratings.
Because baby boomers are aging into Medicare at a rapid clip, Medicare Advantage, the managed-care version of the program, has exploded, giving insurers access to huge sums of taxpayer-funded revenue. In 2016, 31%, or 17.6 million, of Medicare enrollees were in a Medicare Advantage plan, compared with 5.3 million in 2004, according to the Kaiser Family Foundation.
Star ratings are usually what draw consumers to Advantage plans. And insurers will once again see who's gaining beneficiaries as open enrollment for Medicare ends this week. During the nearly two-month window, Medicare beneficiaries have been able to switch from traditional Medicare to an Advantage plan or vice versa.
For 2017, UnitedHealth expects more than 80% of its Advantage membership will be in plans rated four stars or higher. This year UnitedHealth invested in improving the quality of its plans and shifted members into plans with better care coordination and clinical protocols.
Anthem expects 51% of its Advantage members will be enrolled in plans that achieve four stars or higher, CEO Joseph Swedish said in an earnings call last month. “The improvement is the direct result of investments made in the Medicare program over the past three years,” Swedish said.
UnitedHealth could lose its top spot if federal and state regulators sign off on the pending merger of Aetna and Humana. The combined company would be a highly rated, powerful Advantage marketer in the individual and group segments.