UnitedHealthcare 2019 Star Ratings Results

October 16, 2018

Star Ratings, UnitedHealthcare

On Oct. 10, the Centers for Medicare & Medicaid Services (CMS) released our 2019 Star Ratings plan year performance (2020 payment year) for Medicare Advantage plans that includes Individual, Part D, Group Retiree and Dual Special Needs Plans.

UnitedHealthcare is committed to delivering clinical quality, access to care and a distinctive experience for the members we’re privileged to serve.

Our focus on these commitments has enabled us to maintain solid Star Ratings, with an expected 69 percent of our Medicare Advantage members to be in plans rated four stars or higher for 2019 Star Ratings plan year (2020 payment year).

Although the published results show an expected 69 percent of our Medicare Advantage members will be in plans rated four stars or higher for the 2019 Star Ratings plan year (2020 payment year), we anticipate that our results will improve in the following ways.

  • When we include several known factors, like new plans that are not yet rated and will be paid at the overall average UnitedHealthcare four star rating, we expect 71 percent of our Medicare Advantage members will be in plans rated four stars or higher.
  • Additionally, we are in discussions with CMS regarding one contract in particular that, based on our data, is operating at a four-star level. They have acknowledged this concern, and we are pleased with our ongoing dialogue, which would result in nearly 77 percent of our members in plans rated four stars or higher.

The 2019 Star Ratings were published by the Centers for Medicare & Medicaid Services (CMS). Access the new ratings on the Medicare.gov website.

As an agent, what does this mean?

  • You are required to communicate the 2019 Star Rating for the plan(s) you present during formal and informal marketing/sales events, one-on-one marketing appointments or telephonically.
  • You must use updated ratings information within 21 calendar days of the release, meaning that beginning November 1, 2018, agents are required to distribute the 2019 Star Ratings information from Medicare.gov with the Enrollment Guide as well as refer to the new information at the point of sale. Use this ‘how-to’ guide for finding ratings on the  Medicare.gov website

Navigating consumer conversations
Star Ratings may come up in conversations with consumers this Annual Enrollment Period (AEP). Here is a guide to help you navigate those!

What should I tell consumers who ask about when Star Ratings might change again?
The Centers for Medicare & Medicaid Services (CMS) uses Star Ratings to rate the quality for Medicare Advantage Plans. Star Ratings measure plans across a number of performance categories – including clinical quality, health plan operations and member satisfaction – on a scale of one to five, with five stars being the highest rating. 

Star Ratings are published by CMS only one time per year (typically in October with no updates in between).

Be careful when discussing Star Ratings to avoid using superlatives. When discussing Star Ratings with consumers, the Star Rating should always be given as a number. For example, if a plan is 3.5 stars, the verbiage to the consumer would be, “This plan is rated 3 and a half out of 5 stars.” Agents should never use descriptive terms such as good, pretty good, high, etc., when describing Star Ratings.

Can I give the consumer a printout of the new rating fromwww.Medicare.gov?
Yes. This is public information and is posted on www.Medicare.gov. Consumers are able to access this information. It is appropriate to offer a printout to the consumer from this website. However, agents cannot use Star Ratings to disparage competitors, Medicare or the federal government.

Can I use existing inventory of Enrollment Guides?
Yes. Agents are not required to destroy their inventory, although they are required to communicate the most current Star Ratings. Consumers can access those ratings on the Medicare.gov website. Enrollment Guides with updated Star Rating information will be available on Jarvis. Agents will receive communication when the updated guides are available.

What can I do to provide consumers with updated Star Ratings between now and when UnitedHealthcare issues a new Enrollment Guide?
As of October 10, 2018, you can view the 2019 Star Ratings on Medicare.gov. Remember, you are required to provide updated Star Ratings to all consumers as a part of the sales presentation, so be prepared to provide 2019 Star Rating information from Medicare.gov until you have updated Enrollment Guides.

More information
Find more information in the Star Ratings FAQ.