CMS nudges beneficiaries away from low-performing MA plans

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Letter: Assisted living group pushes for industry involvement to prevent 'pension poaching'
Letter: Assisted living group pushes for industry involvement to prevent 'pension poaching'

The Centers for Medicare & Medicaid Services is encouraging around 375,00 Medicare Advantage members to re-evaluate their plans.

Letters sent to beneficiaries of 26 low-performing plans ask the individuals to “compare this plan to other options in your area.”

There are about 13.3 million Medicare Advantage members, many of whom use their coverage to pay for skilled nursing and other post-acute services.

The effort, which is the first time officials have tried to nudge beneficiaries away from specific private drug and medical plans, reflects the agency's increasing focus on quality ratings. CMS forbade one of the 26 plans from enrolling new members in October, and similar actions for other low-rated plans are expected.

The letters, sent out over the past week, tell the beneficiary, by name, that his or her plan has been listed as “poor” or “below average" since for three years running, it earned fewer than three stars under Medicare's five-star rating system.

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