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Anthem Gets High Medicare Star Quality Ratings from CMS


Anthem Inc. ANTM recently announced that it has received high Medicare Star Quality Ratings from the Centers for Medicare & Medicaid Services (“CMS”). The ratings have been assigned for the insurer’s Medicare Advantage (MA) plans for 2017.

The superior ratings from CMS acknowledge the company’s continued investments to strengthen its Medicare program. The ratings take into account that approximately 51% of Anthem’s MA members will be enrolled in plans with four stars or higher for 2017 as against 22% members enrolled in such plans in 2016.

Anthem regularly undertakes initiatives to improve the quality and reach of its MA plans. The frequent restructuring of its product portfolio to meet the changing health insurance demands of customers is also notable. Anthem’s prioritization on continuous reframing of its MA plans has not only helped it to retain its existing customers but also has paved the way to achieve a bigger market share.

In order to deliver high quality services to its customers, Anthem has been investing in its MA programs. Moreover, the company has working to broaden its product portfolio, expand its services area, increase the number of staffs involved in practicing the local health plan and strengthen provider and member engagement.

Anthem believes that its efforts have been correctly identified by CMS as is evidenced by the aforesaid star quality ratings. We expect these ratings to further motivate Anthem to continue delivering services to ensure complete customer satisfaction.


CMS’ Medicare Star Rating system is based on two parameters – quality and performance of the concerned business segment. Hence, MA plans are rated on the basis of their ability to help members stay healthy, the extent to which they assist members in managing chronic diseases, their ability to ensure positive member experiences and member satisfaction as well as their capability of providing effective customer service.

On the other hand, Medicare Prescription Drug plans are rated on their performance on drug plan customer service, the frequency and extent of member complaints, member experience with drug plan and the safety assured by the drug. A scale of one to five stars (with five being the best) is used for the calculation of star ratings.

Aetna Inc. AET too has received high Medicare Star Quality Ratings for its Medicare Advantage Prescription Drug (MAPD) plans for 2017 from the CMS. This upgrade reflected Aetna’s increased member base in plans with a star rating of four or higher than 91%, representing a 4 percentage point increase from last year.

Humana Inc. HUM, however, witnessed a downgrade in the CMS star quality ratings for 2018. This is because Humana’s membership in four-star or higher rated plans as of Jul 31, 2016 has declined to 37% from the year-ago level of 78%.

Cigna Corp. CI has also received star quality ratings from CMS as approximately 20% of MA customers were in a four stars or higher rated plan. However, it is unlikely to have any financial impact in 2016 or 2017 as these ratings apply to plans for 2018.

Anthem presently carries a Zacks Rank #4 (Sell). You can see the complete list of today’s Zacks #1 Rank (Strong Buy) stocks here.

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