CVS Health’s company will be hit by up to $1 billion in 2024 due to a low Medicare Benefit star rating, the business mentioned in a filing with the Securities and Exchange Commission (SEC) these days.
Only 21% of men and women in the company’s Medicare Benefit plans had been in plans with a 2023 star rating of four. or larger, compared with 87% in 2022, according to SEC filings.
The Centers for Medicare and Medicaid Solutions (CMS) utilizes its star ratings to ascertain which Medicare Benefit plans qualify for good quality bonuses. Plans with a rating of four. or larger might obtain good quality bonuses on their premiums
CVS’s 2024 operating earnings is impacted by the 2023 ratings for the reason that CMS utilizes the 2023 ratings to ascertain eligibility for 2024 bonuses.
Contemporary Healthcare was the very first to report on the SEC submission.
Star ratings are primarily based on measures of Medicare Benefit coverage of preventive care and chronic illness management, as effectively as user satisfaction.
In an SEC filing, CVS mentioned the key driver of the sharp drop in the quantity of members covered by bonus-eligible plans was a 1-star reduction in Aetna National’s preferred provider organization.