Touting growth, sweating star ratings: What payer CEOs said about Medicare Advantage this fall

Medicare Advantage open enrollment is underway, and payers are expecting to see even more older adults choose the plans over traditional Medicare. 

As payers expand markets and plan for growth, some are concerned about the impact of CMS' plan quality ratings, which determine the quality bonus payments payers are eligible for from the federal government. The end of pandemic-era methodologies meant many plans saw their ratings take a hit. 

Here's what CEOs told their investors about the state of their Medicare Advantage business on third quarter earnings calls. 

Centene 

Centene alerted investors in July it expected its star ratings to drop. 

"While the final results were slightly worse than our internal expectations, the vast majority of the revenue headwind was known to us months in advance, as we shared transparently with the investment community," Centene CEO Sarah London said in an Oct. 25 earnings call. 

Ms. London told investors the company is prioritizing improving quality performance, including hiring a chief quality officer and making quality improvement a part of every employee's compensation. 

"When I say quality is a priority, I mean it," Ms. London said. "Over the next three cycles, our goal is to achieve at least 60 percent of members in four-star plans. And I promise you, this senior management team is aggressively tracking stars improvement toward that goal on a real-time basis."

Cigna 

Cigna CEO David Cordani painted a rosy picture of the insurer's Medicare Advantage offerings as the company expands to new markets. 

"Looking at 2023, given the continued geographic expansion, we've made network improvement," Mr. Cordani said on a Nov. 3 earnings call. "We've made investment in distribution and marketing support as well as more resources and capabilities to begin to harness some of the commercial agents to Medicare. We expect 2023 to be a year of growth for our Medicare Advantage portfolio." 

CVS Health 

CVS Health CEO Karen Lynch touted the company's Medicare Advantage plans during an earnings call on Nov. 2. Ms. Lynch said 73 percent of Aetna Medicare Advantage plans have $0 premiums. 

Ms. Lynch said said CVS executives are "dissapointed" that its national PPO contract star rating was downgraded by CMS. 

"Improving our star performance continues to be a top priority for the company. We have the right actions in place to improve our star rating with our ongoing quality and experience efforts as we address the specific measures scored on the member surveys that contribute to star ratings," Ms. Lynch said. 

Elevance Health 

CEO Gail Boudreaux told investors on an Oct. 19 call Elevance Health is expanding its Medicare Advantage offerings and is positioned for another year of growth. 

Ms. Boudreaux said the company is "pleased" with its HealthSun Health Plans in Florida, which received a five-star rating from CMS for the sixth year in a row. 

"In aggregate, we did see a modest drop in the percentage of our members in four-star or higher-rated plans for the 2024 payment year, predominantly due to the end of COVID era relief," Ms. Boudreaux said. "And while we will decline by less than the overall industry, we remain intensely focused on our long-term goal of achieving and maintaining star ratings at the high end of all Medicare Advantage plans in our markets."

 Ms. Boudreaux said the company is "very well positioned" for future Medicare Advantage growth. 

Humana 

Bruce Broussard, Humana's CEO, said the company expects to add 325,000 to 400,000 Medicare Advantage members in 2023. 

Mr. Broussard told investors on a Nov. 2 call that early in the annual enrollment period, the number of new sales is higher than expected. 

"So, what we see early on is just a really exciting aspect of where we're seeing good growth, and that good growth is coming across all parts of the organization with continued improvement in our relationships with the channels," he said. 

UnitedHealthcare

UnitedHealthcare also touted strong growth in Medicare Advantage. 

UnitedHealth Group CFO John Rex told investors on an Oct. 14 call the insurer added 800,000 Medicare Advantage members this year and received CMS star ratings in line with their expectations. 

On the call, UnitedHealth Group CEO Andrew Witty praised health outcomes from Medicare Advantage plans. 

"[Medicare Advantage] plays a vital role in serving those consumers who are significantly more diverse, have lower incomes, and more complex care needs than the average senior. There are compelling reasons why seniors increasingly choose MA," Mr. Witty said. "Through Medicare Advantage, people are experiencing better health outcomes than in traditional fee-for-service Medicare across a wide spectrum of measures." 

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