If a Medicare Advantage plan has been awarded a 5 Star rating from Medicare you’ll see that trumpeted in TV commercials and print advertising. The star rating that either the Medicare Advantage or Part D Prescription Drug plan must display is a composite of 35 different measurements. Perhaps the most important rating for most beneficiaries is the level of customer service if there is a problem.
Medicare Fact Sheet 2014 Star Rating Fact Sheet
Star Ratings are driving improvements in Medicare quality. This year there have been significant increases in the number of Medicare beneficiaries in high-performing Medicare Advantage (MA) plans. The information included in this Fact Sheet is based on the 2014 Star Ratings published on Medicare Plan Finder on October 8, 2013. The Centers for Medicare & Medicaid Services (CMS) publishes the Star Ratings each year to assist beneficiaries in finding the best plan for them and to determine Medicare Advantage Quality Bonus Payments. Moreover, they support the efforts of CMS to improve the level of accountability for the care provided by physicians, hospitals, and other providers, including enrollees of Medicare Advantage and Prescription Drug Plans. (2014 Part C and D Plan Ratings, Medicare)
California Medicare Advantage Customer Experience 2014
| Contract Number | Contract Name | C25: Getting Appointments and Care Quickly | C26: Customer Service |
| 02/15/2013 – 05/31/2013 | 02/15/2013 – 05/31/2013 | ||
| H0523 | AETNA HEALTH OF CALIFORNIA INC. | 2 | 4 |
| H0564 | BLUE CROSS OF CALIFORNIA | 3 | 3 |
| H6229 | BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | * | * |
| H8764 | ASPIRE HEALTH PLAN | * | * |
| H0504 | CALIFORNIA PHYSICIANS’ SERVICE | 2 | 3 |
| H0838 | UNIVERSAL CARE, INC. | 2 | 2 |
| H8016 | ORANGE COUNTY HEALTH AUTHORITY | * | * |
| H0148 | CARE1ST HEALTH PLAN | * | * |
| H5928 | CARE1ST HEALTH PLAN | 1 | 3 |
| H0544 | CAREMORE HEALTH PLAN | 2 | 4 |
| H5649 | CENTRAL HEALTH PLAN OF CALIFORNIA, INC. | 2 | 2 |
| H0571 | CHINESE COMMUNITY HEALTH PLAN | 1 | 4 |
| H3815 | CITIZENS CHOICE HEALTHPLAN | 2 | 4 |
| H5087 | EASY CHOICE HEALTH PLAN INC. | 1 | * |
| H5609 | GEMCARE HEALTH PLAN INC. | 4 | 4 |
| H2241 | GOLDEN STATE MEDICARE HEALTH PLAN | 4 | 5 |
| H5439 | HEALTH NET LIFE INSURANCE COMPANY | 4 | 1 |
| H5520 | HEALTH NET LIFE INSURANCE COMPANY | 5 | 2 |
| H0562 | HEALTH NET OF CALIFORNIA,INC. | 4 | 3 |
| H5428 | SAN MATEO HEALTH COMMISSION | 2 | 3 |
| H7885 | SAN MATEO HEALTH COMMISSION | * | * |
| H0108 | HUMANA HEALTH PLAN OF CALIFORNIA, INC. | 2 | 3 |
| H0545 | INTER VALLEY HEALTH PLAN, INC. | 2 | 5 |
| H1230 | KAISER FOUNDATION HP, INC. | 5 | 4 |
| H0524 | KAISER FOUNDATION HP, INC. | 5 | 4 |
| H8258 | LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY | * | * |
| H2643 | LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY | 1 | 2 |
| H5810 | MOLINA HEALTHCARE OF CALIFORNIA | 1 | 1 |
| H8677 | MOLINA HEALTHCARE OF CALIFORNIA | * | * |
| H7890 | SANTA CLARA COUNTY HEALTH AUTHORITY | * | * |
| H5425 | SCAN HEALTH PLAN | 4 | 4 |
| H5811 | SCAN HEALTH PLAN | 4 | 4 |
| H9104 | SCAN HEALTH PLAN | 4 | 4 |
| H0543 | UHC OF CALIFORNIA, INC. | 4 | 3 |
| *Not enough data or too new to rate |
Average star rating nationwide for all measurements
| Average Star Rating by Part C Measure | 2014 |
| Breast Cancer Screening | 3.3 |
| Colorectal Cancer Screening | 3.9 |
| Cardiovascular Care – Cholesterol Screening | 4.3 |
| Diabetes Care – Cholesterol Screening | 3.8 |
| Glaucoma Testing | 3.4 |
| Annual Flu Vaccine | 3.4 |
| Improving or Maintaining Physical Health | 4.5 |
| Improving or Maintaining Mental Health | 2 |
| Monitoring Physical Activity | 2.4 |
| Adult BMI Assessment | 3.8 |
| Care for Older Adults – Medication Review | 3.6 |
| Care for Older Adults – Functional Status Assessment | 3.4 |
| Care for Older Adults – Pain Screening | 3.2 |
| Osteoporosis Management in Women who had a Fracture | 1.9 |
| Diabetes Care – Eye Exam | 4 |
| Diabetes Care – Kidney Disease Monitoring | 4.5 |
| Diabetes Care – Blood Sugar Controlled | 3.3 |
| Diabetes Care – Cholesterol Controlled | 3.5 |
| Controlling Blood Pressure | 3.5 |
| Rheumatoid Arthritis Management | 3.7 |
| Improving Bladder Control | 2.3 |
| Reducing the Risk of Falling | 3.4 |
| Plan All-Cause Readmissions | 3.5 |
| Getting Needed Care | 3.6 |
| Getting Appointments and Care Quickly | 3.5 |
| Customer Service | 3.5 |
| Rating of Health Care Quality | 3.7 |
| Rating of Health Plan | 3.4 |
| Care Coordination | 3.4 |
| Complaints about the Health Plan | 3 |
| Beneficiary Access and Performance Problems | 3.4 |
| Members Choosing to Leave the Plan | 3.7 |
| Health Plan Quality Improvement | 3.5 |
| Plan Makes Timely Decisions about Appeals | 4.1 |
| Reviewing Appeals Decisions | 3.3 |
| Call Center – Foreign Language Interpreter and TTY Availability | 4.4 |
California Medicare Advantage Plan Star Ratings
Part C is just for the medical portion of the MA plan. The overall rating includes the Part D prescription drug component of the MA-PD plans.
| Contract Name | Contract Number | 2014 Part C Summary Rating | 2014 Overall Rating |
| AETNA HEALTH OF CALIFORNIA INC. | H0523 | 3.5 | 3.5 |
| BLUE CROSS OF CALIFORNIA | H0564 | 3.5 | 3.5 |
| BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. | H6229 | * | * |
| ASPIRE HEALTH PLAN | H8764 | * | * |
| CALIFORNIA PHYSICIANS’ SERVICE | H0504 | 4 | 4 |
| UNIVERSAL CARE, INC. | H0838 | 2.5 | 3 |
| ORANGE COUNTY HEALTH AUTHORITY | H8016 | * | * |
| CARE1ST HEALTH PLAN | H0148 | * | * |
| CARE1ST HEALTH PLAN | H5928 | 3.5 | 3.5 |
| CAREMORE HEALTH PLAN | H0544 | 4 | 4 |
| CENTRAL HEALTH PLAN OF CALIFORNIA, INC. | H5649 | 3.5 | 3.5 |
| CHINESE COMMUNITY HEALTH PLAN | H0571 | 3.5 | 4 |
| CITIZENS CHOICE HEALTHPLAN | H3815 | 3.5 | 3.5 |
| EASY CHOICE HEALTH PLAN INC. | H5087 | 3 | 3 |
| GEMCARE HEALTH PLAN INC. | H5609 | 4 | 4 |
| GOLDEN STATE MEDICARE HEALTH PLAN | H2241 | * | * |
| HEALTH NET LIFE INSURANCE COMPANY | H5439 | 3 | 3 |
| HEALTH NET LIFE INSURANCE COMPANY | H5520 | 4 | 4 |
| HEALTH NET OF CALIFORNIA,INC. | H0562 | 4 | 4 |
| SAN MATEO HEALTH COMMISSION | H5428 | 3.5 | 3.5 |
| SAN MATEO HEALTH COMMISSION | H7885 | * | * |
| HUMANA HEALTH PLAN OF CALIFORNIA, INC. | H0108 | 3 | 3.5 |
| INTER VALLEY HEALTH PLAN, INC. | H0545 | 3.5 | 4 |
| KAISER FOUNDATION HP, INC. | H1230 | 4.5 | 5 |
| KAISER FOUNDATION HP, INC. | H0524 | 4.5 | 5 |
| LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY | H8258 | * | * |
| LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY | H2643 | 3.5 | 3 |
| MOLINA HEALTHCARE OF CALIFORNIA | H5810 | 3 | 3 |
| MOLINA HEALTHCARE OF CALIFORNIA | H8677 | * | * |
| SANTA CLARA COUNTY HEALTH AUTHORITY | H7890 | * | * |
| SCAN HEALTH PLAN | H5425 | 4.5 | 4.5 |
| SCAN HEALTH PLAN | H5811 | 3.5 | 3.5 |
| SCAN HEALTH PLAN | H9104 | 3.5 | 3.5 |
| UHC OF CALIFORNIA, INC. | H0543 | 3.5 | 4 |
| *To new to rate |
Testings Medicare Advantage customer service
Perhaps the best customer service test is to actually call member services of the Medicare Advantage plans you are thinking of enrolling in.
- How long does it take them to answer?
- How long are you on hold before you talk to a representative?
- Can you understand the customer service representative?
- Do they give you the opportunity to select your language preference?
- How many buttons do you have to push to speak to a human?
There is one MA-PD plan that has all their customer service representatives located in the south eastern part of the United States. As an agent, I never really wait long to talk to a representative. They are mature, courteous, and knowledgeable. As much as I love this crew, they may not be a good match for some of my clients where English is a second language. On the west coast, Medicare Advantage plans based in California have the edge for having multiple languages represented on the customer service desk.
Spreadsheet of all California measurement star ratings
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