Better choices for Floridians on Medicare may be in the stars for next year.
There are three times more Medicare Advantage plans in Broward and Palm Beach counties that earned above-average rankings for 2014 in Medicare's five-star rating system than there were for the previous year.
When shopping for health care, South Florida seniors can pick from 54 managed-care style plans that earned four stars or more — about 37 percent of the total 144 offered in both counties. That's a huge difference from last year, when consumers had access to only 17 above-average plans, or about 10 percent of the 163 South Florida choices listed on Medicare's online Plan Finder for 2013.
Edith Gooden-Thompson, Broward County coordinator for Florida's Serving Health Insurance Needs of Elders program (SHINE), said the growing number of top-rated offerings is good news for seniors who look to the stars when making their Medicare decisions.
Open enrollment in the Medicare Advantage and stand-alone prescription drug plans offered through private insurers approved by Medicare began Oct. 15 and will end Dec. 7. SHINE volunteer counselors, who work through a government-funded program and don't sell policies, help seniors review coverage and decide whether to stay with it or switch.
"We have some who tell us they only want the best, and flat-out ask for a five-star plan," Gooden-Thompson said.
There are no top-rated offerings in Broward and Palm Beach counties this year or next. But Cigna-HealthSpring earned five stars for 2014 for coveragethrough Leon Medical Centers, which serves Miami-Dade residents, as well as plans in Bay, Escambia and Santa Rosa counties. There were no five-star Florida choices in 2013.
Federal officials say the upward trend is a sign that providers are ramping up customer service, chronic care management and safety standards — all among the more than 50 factors the Centers for Medicare and MedicaidServices measures when calculating a plan's rating.
Star rankings also are up nationally and statewide. Forty-five percent of Florida's Medicare Advantage plan contracts earned above-average rankings for 2014 as compared with 18 percent in 2013, according to Q1Group LLC, a St. Augustine research firm that analyzes Medicare coverage.
But experts say there's no research that proves the rankings are spurring more enrollment in top-rated coverage, as CMS has hoped. "The jury still is out in terms of how stars affects plan choice," said Gretchen Jacobson, associate director with the Kaiser Family Foundation's Program on Medicare Policy.
Shelly Siskin, a retired insurance broker and area coordinator for Palm Beach County's SHINE program, said he finds price and the doctors in a plan network loom much larger than star ratings when decision time comes.
"There has been a lot of shifting around this year, as people find a plan that was cheap last year is not so cheap this year," Siskin said. Still, he advises seniors to go with no fewer than three stars.
The Centers for Medicare and Medicaid Services originally created the five-star system in 2007 as a consumer-friendly tool for comparing plans. But in 2012, federal officials started using the rankings as a way to increase care quality by rewarding top performers and punishing underachievers.
The Centers is giving graduated bonus payments through 2014 to insurers whose plans rate three stars or more. And five-star providers earn additional rewards; seniors and disabled adults can switch to those plans at any time, rather than just sign up during open enrollment.
At the other end, poor performers are flagged with a warning sign on the Plan Finder, and seniors can't automatically re-enroll in them through the site. Members of plans earning fewer than three stars for three consecutive years also receive letters before open enrollment, suggesting they look for an alternative.
In 2013, there were 22 plans in Broward and Palm Beach counties labeled poor performers, the vast majority from St. Petersburg-based Universal Health Care. Universal declared bankruptcy early this year as federal agents investigated possible fraud, leaving plan participants searching for new coverage.
There are only two South Florida plans with a poor performance rating in 2014: one United Healthcare AARP HMO in Palm Beach County, and another in Broward.
"We remain committed to improving our star ratings," United Healthcare officials said in a written statement. "We are actively working to improve our results in these plans to help ensure our members receive quality service and support for their health care needs."
Humana, which has the most above-average rated plans in South Florida, has increased its focus on preventive care due to the star-rating incentives, said spokeswoman Nancy Hanewinckel.
"The goal is for people to use the ratings to become smarter health care consumers," Hanewinckel said.