Medicare Advantage Plans’ Quality Ratings From CMS Fall Again
Only 40% of Medicare Advantage health prescription drug plans achieved a four-star rating or higher under the current criteria used by Centers for Medicare and Medicaid Services to grade quality. The federal health agency has sought to make it harder to win top scores — in 2022, 68% of plans were four stars or higher.
Reuters:
US Health Agency Releases 2025 Quality Ratings For Medicare Plans
The U.S. government announced quality ratings for 2025 Medicare health and prescription drug plans on Thursday, the first indication of which large health insurers, including CVS Health, UnitedHealth Group and Humana, will get bonus payments in 2026. Sixty-two percent of people currently enrolled in Medicare Advantage plans that cover prescription drugs are covered by plans rated four or more stars, the Medicare agency said in its release, down from 74% last year. (Niasse, 10/11)
Modern Healthcare:
Aetna, UnitedHealth Fall In 2025 Medicare Advantage Ratings
The Centers for Medicare and Medicaid Services sought to make it more challenging for Medicare Advantage insurers to win top quality scores and the payment bonuses that go along with them. It's working. On Thursday, CMS released the latest Medicare Advantage star ratings, and the contrast to just a few years ago is stark. In 2022, 74 Medicare Advantage with prescription drug coverage contracts garnered five-out-of-five stars. For the 2025 plan year, only seven did. (Tepper and Broderick, 10/10)
Becker's Hospital Review:
Hospitals Sick Of Fighting For Medicare Advantage Dollars
Health systems are growing increasingly frustrated with fighting to receive payments from insurers in the Medicare Advantage program, which now provides health coverage to more than 55% of the nation's older adults, about 33.8 million people. MA continues to grow, but so do its administrative challenges, as health insurers prioritize their margins in the segment. (Condon, 10/10)
AP:
Social Security Recipients Will Get 2.5% COLA Boost In 2025
Millions of Social Security recipients will get a 2.5% cost-of-living increase to their monthly checks beginning in January, the Social Security Administration announced Thursday. The cost-of-living adjustment, or COLA, for retirees translates to an average increase of more than $50 for retirees every month, agency officials said. About 72.5 million people, including retirees, disabled people and children, get Social Security benefit. But even before the announcement, retirees voiced concern that the increase would not be enough to counter rising costs. (Hussein, 10/10)
Modern Healthcare:
FTC Merger Rule Updating Hart-Scott-Rodino Act Form Finalized
Healthcare companies pursuing mergers and acquisitions will be required to submit additional information about their proposals under a final rule approved by the Federal Trade Commission Thursday. The final rule amends the Hart-Scott-Rodino Act form, which had not been updated for 46 years. When the rule goes into effect, likely early next year, healthcare companies involved in M&A proposals must list acquisitions that occurred within the last five years, disclose private equity and minority stakeholders with decision-making authority and report supplier relationships shared by the merging parties to the FTC, among other requirements. (Kacik, 10/10)
From Congress —
The Wall Street Journal:
Warren Toughens Private-Equity Bill, Aiming To Prevent Healthcare Abuses
A group of Democrats led by Sen. Elizabeth Warren proposed new restrictions on private-equity firms, saying tougher rules are needed to prevent buyout firms from “looting” the businesses they own in the wake of hospital operator Steward Health Care System’s bankruptcy. On Thursday, six senators and eight U.S. representatives announced the Stop Wall Street Looting Act of 2024, an updated version that puts more teeth in a measure Warren, a Massachusetts Democrat, has pushed since 2019. (Cumming, 10/10)
