Here are eight recent Medicare Advantage updates Becker’s has reported since Oct. 1.
- Health systems are growing increasingly frustrated with fighting to receive payments from insurers in the Medicare Advantage program.
- Average Medicare Advantage star ratings declined for the third year in a row, according to CMS data. The average Medicare Advantage star rating for 2025 is 3.92, down from 4.07 in 2024. Just seven plans achieved a 5-star rating from CMS for 2025.
- Zing Health is plotting an expansion in the Medicare Advantage market. The Chicago-based insurer recently picked up a $140 million funding round in September. Zing Health CEO Andrew Clifton sat down with Becker’s to explain the company’s growth outlook and the challenges and opportunities in the chronic special needs market.
- UnitedHealthcare is asking a federal court to prevent CMS from downgrading its Medicare Advantage star ratings based on one phone call. In a lawsuit filed in the U.S. District Court in the Eastern District of Texas, the insurer argued CMS is poised to downgrade its star ratings “based upon a single phone call that lasted less than [10] minutes.”
- Just two Medicare Advantage plans received five-star ratings from the National Committee for Quality Assurance for 2024. Executives at both plans told Becker’s clinical integration and a focus on quality improvement were key to achieving the top rating.
- The percentage of Humana Medicare Advantage members enrolled in plans rated 4 stars or higher for 2025 has dropped significantly. The company expects the drop to hurt its revenues in 2026.
- Premera Blue Cross will no longer offer Medicare Advantage plans in 2025. The exit was driven by “changing market conditions and financial pressures,” the company said. Premera will continue to offer Medicare supplement plans in Washington and Alaska.
- In 22 states and Washington, D.C., there will be fewer Medicare Advantage plans available in 2025 than in 2024, according to CMS data. Pennsylvania will see the largest number of plan exits in 2025, with 35 fewer plan options available than in 2024.
