CVS expects its 2024 operating income to drop by $800 million to $1 billion next year due to lost bonus payments from lower plan star ratings in the Medicare Advantage program, Health Care Dive reports.
Just 21% of CVS’ MA members are currently in plans with a star rating of at least four, down from 87% at the end of 2021, the payer disclosed in a filing with the Securities and Exchange Commission. Plans with a rating of four or above are eligible for bonus payments.
CVS’ score for its largest MA plan, Aetna National PPO, dropped from 4.5 to 3.5 stars. That was the main driver of the overall decrease in MA members in highly rated plans, CVS said. As a result, the plan — one of the largest in the U.S., with more than 1.9 million members — is no longer eligible for quality bonus payments in 2024. Read more.
