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Medicare Advantage Quality Ratings Impact Enrollment

For first-time enrollees, enrollees switching plans, likelihood of enrollment up with higher rating

TUESDAY, Jan. 15 (HealthDay News) -- For Medicare Advantage first-time enrollees and enrollees switching plans, there is an association between the quality rating and enrollment, according to a study published in the Jan. 16 issue of the Journal of the American Medical Association.

To examine the correlation between publicly-reported Medicare Advantage plan quality ratings and enrollment, Rachel O. Reid, of the Centers for Medicare & Medicaid Services (CMS) in Baltimore, and colleagues conducted a cross-sectional study involving 2011 Medicare Advantage enrollments. Enrollees included 952,352 first-time enrollees and 322,699 enrollees switching plans.

For first-time enrollees, the researchers found that a 1-star higher rating correlated with a 9.5 percent increase in the likelihood of enrollment. The highest rating available to a beneficiary correlated with a 1.9 percent increase in the likelihood of enrollment. For enrollees switching plans, the increases in likelihood of enrollment were 4.4 percent with a 1-star higher rating and 6.3 percent with a rating at least as high as the beneficiary's previous plan. For black, rural, low-income, and the youngest beneficiaries, the correlation between star ratings and enrollment was less robust.

"We found a positive association between CMS's 5-star Medicare Advantage quality ratings and enrollment," the authors write. "Bolstering the business case for quality in the Medicare Advantage market, these findings may provide firms with additional incentive to cultivate higher quality, CMS with justification to continue to advance public reporting, and policy makers with a rationale to pursue quality reporting in other health insurance markets."

One author disclosed financial ties to the health insurance and health technology industries.

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