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Targeted Measures Slope
Member Experience Impact
Stars Bonus
Competition

Plan Screener

 
 
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Priority Deciles for Filtering and Sorting Contract Details Plan History Star Ratings Financials Based on 2017 Bid and Projected Stars (use with caution) Selected Measures Calculation
Priority Rank
Total of the deciles for selected columns
Targeted Measures Slope
Decile based on this calculation - (1) Use linear regression on the past 4 years of stars results for each measure (2) Take the average for the measures that are configured for your client account.
Member Experience Impact
Decile of the difference between the actual overall 2022 Star Rating and the rating recalculated with Member Experience at 4x instead of 2x.
Stars Bonus
Decile of the difference between the 5% Bonus Benchmark (4 Stars) and the 0% Benchmark (< 4 Stars)
Competition
Decile of the number of plans available (with actual enrolled members) in each county where Plans' members reside.
Member Experience Impact
Decile of the difference between the actual overall 2022 Star Rating and the rating recalculated with Member Experience at 4x instead of 2x.
Competition
Decile of the number of plans available (with actual enrolled members) in each county where Plans' members reside.
Hcontract
Medicare Plan Number
Population
Current Population
Marketing Name
Marketing Name
Parent Organization
Parent Organization/Company
States
States where members are enrolled
Size Category
Category of plan size (1k/10k/50k members)
Age Category
Category of the age of the plan
Special Needs Plan
Special Needs Plan Y/N
Population (2024)
Prior Year Population
Plans Per Member (by county)
** This gets merged wit the decile above ***
Plan First Year
The first year the plan had members
Plan First Rating Year
The first year the plan had a star rating
First Year for Parent Org
First Year for Parent Org
2022-2025 Star Ratings
Last 4 year's star ratings
Star Average 2025
Calculated Star Rating w/out adjustments
Star Average 2024
Calculated Star Rating for 1 Year Ago
Star Average 2023
Calculated Star Rating for 2 Years Ago For Previous Previous year's Star Average : Sum(Avg Star * star_wt) / sum(star_wt)
Star Average 2022
Calculated Star Rating for 3 Years Ago
Stars Bonus
Decile of the difference between the 5% Bonus Benchmark (4 Stars) and the 0% Benchmark (< 4 Stars)
Projected Future Star
Star Rating Calculated from average past measure ratings with future measure weights
2025 Baseline Benchmark
Weighted average CMS county benchmark without bonus
2025 5% Bonus (4-Star) Benchmark
Weighted average CMS county benchmark with 5% bonus
Risk Factor 2017
Plan average HCC from 2017 CMS Data
Rebate 2017
Plan average Rebate from 2017 CMS Data
Profit 2017
Plan average Profit from 2017 CMS Data
Expenses 2017
Plan average Expenses (medical + admin) from 2017 CMS Data
Bonus at Next Star
TBD
Targeted Measures Slope
Decile based on this calculation - (1) Use linear regression on the past 4 years of stars results for each measure (2) Take the average for the measures that are configured for your client account.
Bonus at Next Star PMPY
TBD
Targeted Stars List
List of scores for the selected measures
Targeted Star Avg
Average star rating for selected measures
Targeted Star Variance
Average difference between Plan's rating and the CMS published average rating for selected measures
Star Rating Trend
40 10 10 10 10 1 73.17 H1423 6,122 Amerigroup Elevance Health Inc. AZ-100.0% Small New Plan Yes 6,122 73.17 2021 2023 2023 No DataNo Data,No Data,33 2.85 2.94 5 0 79.87 tbd 1,122 1,201 tbd tbd tbd tbd -0.631 tbd HED-COL:4,HED-CDCEYE:4,HED-OMW:4,HED-CDCA1C:3,HED-COAMR:5,HED-MPR:4,HED-COAPS:5,HED-BCS:4,HED-SUPC:2 3.727 0.218
39 10 10 9 10 1 61.64 H9686 2,507 Alignment Health Plan Alignment Healthcare USA LLC NV-100.0% Small Parent Org Established Yes 2,507 61.64 2021 2023 2016 No DataNo Data,No Data,3.53.5 3.46 3.53 5 0 69.53 tbd 1,181 1,251 tbd tbd tbd tbd -0.319 tbd HED-MPR:4,HED-COAPS:5,HED-COL:5,HED-COAMR:5,HED-CDCA1C:5,HED-SUPC:5,HED-CDCEYE:5 4.889 1.3
38 10 9 9 10 1 63.19 H8332 12,707 Aetna Medicare CVS Health Corporation TX-100.0% Medium New Plan Yes 12,707 63.19 2021 2023 2020 No DataNo Data,No Data,3.53 3.15 3.3 5 0 68.43 tbd 1,154 1,222 tbd tbd tbd tbd -0.321 tbd HED-SUPC:3,HED-BCS:4,HED-CDCEYE:4,HED-MPR:5,HED-OMW:4,HED-COL:4,HED-CDCA1C:5 4.333 0.9
38 10 9 9 10 1 59.04 H8849 74,930 Amerigroup Elevance Health Inc. TX-100.0% Large New Plan Yes 74,930 59.04 2021 2023 2023 No DataNo Data,No Data,33 2.97 2.96 5 0 71.46 tbd 1,174 1,245 tbd tbd tbd tbd -0.135 tbd HED-SUPC:3,HED-COAPS:5,HED-COAMR:5,HED-MPR:2,HED-BCS:4,HED-CDCA1C:4,HED-OMW:3,HED-CDCEYE:4,HED-COL:4 3.818 0.309
37 10 8 9 10 1 67.14 H1360 9,500 UnitedHealthcare UnitedHealth Group Inc. NV-100.0% Small Parent Org Established Yes 9,500 67.14 2021 2023 2009 No DataNo Data,No Data,33.5 3.26 3.13 5 0 67.92 tbd 1,198 1,266 tbd tbd tbd tbd -0.765 tbd HED-SUPC:5,HED-CDCEYE:5,HED-COL:3,HED-CDCA1C:3,HED-COAMR:3,HED-MPR:4,HED-COAPS:3 3.556 -0.033
37 10 9 10 8 1 46.82 H3748 23,249 Aetna Medicare CVS Health Corporation WA-100.0% Medium 4+ Yrs Old Yes 23,249 46.82 2020 2022 2020 No DataNo Data,3.5,33.5 3.35 3.15 3.67 5 76.73 tbd 1,094 1,171 tbd tbd tbd tbd -0.115 tbd HED-OMW:3,HED-CDCEYE:4,HED-COL:4,HED-SUPC:4,HED-MPR:5,HED-BCS:4,HED-CDCA1C:5 4.333 0.9
37 10 10 8 9 1 54.39 H1732 35,627 Empire BlueCross BlueShield Elevance Health Inc. NY-100.0% Medium New Plan Yes 35,627 54.39 2021 2023 2023 No DataNo Data,No Data,2.52.5 2.39 2.55 5 0 62.64 tbd 1,197 1,260 tbd tbd tbd tbd -0.18 tbd HED-BCS:4,HED-CDCEYE:2,HED-MPR:2,HED-OMW:2,HED-CDCA1C:3,HED-COAMR:4,HED-COAPS:4,HED-COL:3,HED-SUPC:4 3.091 -0.418
36 10 8 8 10 1 59.83 H4346 12,126 Anthem Blue Cross and Blue Shield Elevance Health Inc. NV-74.4%,CO-25.5% Medium Well Established Yes 12,126 59.83 2010 2012 2023 3.53,3.5,2.53 2.86 2.54 3.33 3.11 65.63 tbd 1,177 1,243 tbd tbd tbd tbd -0.107 tbd HED-MPR:3,HED-BCS:3,HED-OMW:3,HED-CDCA1C:2,HED-COAMR:5,HED-SUPC:2,HED-COAPS:4,HED-CDCEYE:4,HED-COL:3 3 -0.509
36 8 9 9 10 1 63.07 H1019 200,915 CarePlus Health Plans Inc. Humana Inc. FL-100.0% Large Well Established Yes 200,915 63.07 2009 2011 2009 55,5,44 3.91 3.88 4.46 4.52 66.58 tbd 1,120 1,186 tbd tbd tbd tbd 0.033 tbd HED-COL:5,HED-OMW:4,HED-MPR:5,HED-CDCEYE:5,HED-CDCA1C:5,HED-SUPC:4,HED-COAMR:5,HED-COAPS:5,HED-BCS:5 4.818 1.309
35 9 10 9 7 1 41.48 H0672 8,858 Cigna Healthcare The Cigna Group CO-51.6%,OH-31.2%,NM-14.2%,KY-3.0% Small 4+ Yrs Old Yes 8,858 41.48 2020 2023 2024 No DataNo Data,No Data,2.53 2.91 2.55 3.5 5 72.98 tbd 1,095 1,168 tbd tbd tbd tbd -0.063 tbd HED-SUPC:5,HED-COAMR:3,HED-COAPS:4,HED-COL:3,HED-MPR:5,HED-CDCEYE:3,HED-CDCA1C:3,HED-BCS:2 3.4 -0.2
34 8 9 8 9 1 54.77 H4868 58,058 Wellcare Centene Corporation NY-100.0% Large 4+ Yrs Old Yes 58,058 54.77 2018 2021 2009 No Data3.5,3.5,33 3.09 2.86 3.3 3.56 63.79 tbd 1,180 1,244 tbd tbd tbd tbd 0.033 tbd HED-CDCEYE:3,HED-OMW:1,HED-COL:2,HED-SUPC:3,HED-MPR:2,HED-CDCA1C:3,HED-COAMR:3,HED-COAPS:3,HED-BCS:3 2.636 -0.873
34 7 8 10 9 1 56.86 H1099 33,814 Health First Health Plans Inc. Health First Shared Services Inc. FL-100.0% Medium Well Established Yes 33,814 56.86 2009 2011 2022 3.53.5,4,44 3.77 3.8 4.09 3.59 98.39 tbd 1,122 1,221 tbd tbd tbd tbd 0.055 tbd HED-BCS:5,HED-COL:5,HED-OMW:3,HED-MPR:4,HED-CDCEYE:3,HED-CDCA1C:5,HED-SUPC:3 4.222 0.789
34 7 10 10 7 1 41.57 H9047 63,004 Providence Medicare Advantage Plans Providence St Joseph Health OR-94.5%,WA-5.0%, 1 others - 0.6% Large Well Established Yes 63,004 41.57 2009 2011 2024 4.54.5,5,43.5 3.37 3.96 4.29 4.01 89.16 tbd 1,085 1,174 tbd tbd tbd tbd 0.062 tbd HED-MPR:5,HED-BCS:5,HED-OMW:4,HED-CDCA1C:5,HED-COAPS:4,HED-COAMR:5,HED-CDCEYE:5,HED-COL:5,HED-SUPC:4 4.727 1.218
34 9 8 10 7 1 43.57 H5859 17,028 CareOregon Advantage CareOregon Inc. OR-100.0% Medium Well Established Yes 17,028 43.57 2009 2011 2009 3.53.5,4,3.53.5 3.2 3.19 3.81 3.3 86.56 tbd 1,083 1,169 tbd tbd tbd tbd 0.005 tbd HED-COL:3,HED-CDCEYE:4,HED-COAPS:4,HED-OMW:1,HED-COAMR:3,HED-SUPC:4,HED-MPR:5,HED-BCS:2,HED-CDCA1C:4 3.455 -0.055
34 10 10 6 8 1 49.57 H4982 21,393 Aetna Medicare CVS Health Corporation CA-100.0% Medium 4+ Yrs Old Yes 21,393 49.57 2020 2022 2020 No DataNo Data,3,33 2.95 2.81 3.19 5 58.23 tbd 1,145 1,203 tbd tbd tbd tbd -0.175 tbd HED-MPR:3,HED-OMW:4,HED-CDCA1C:5,HED-COAMR:5,HED-COAPS:3,HED-BCS:4,HED-CDCEYE:5,HED-COL:4,HED-SUPC:3 4.182 0.673
34 8 9 9 8 1 49.98 H4711 15,055 Aetna Medicare CVS Health Corporation NV-61.7%,CO-38.3% Medium 4+ Yrs Old Yes 15,055 49.98 2020 2022 2020 No DataNo Data,3,33 2.85 2.83 3.21 5 67.68 tbd 1,149 1,216 tbd tbd tbd tbd 0.041 tbd HED-COAMR:5,HED-MPR:5,HED-COAPS:3,HED-OMW:3,HED-CDCA1C:5,HED-BCS:4,HED-CDCEYE:4,HED-COL:4,HED-SUPC:2 4.091 0.582
33 9 10 6 8 1 49.51 H0544 120,459 Anthem Blue Cross Elevance Health Inc. CA-100.0% Large Well Established Yes 120,459 49.51 2009 2011 2023 43.5,3.5,33 2.71 2.96 3.57 3.45 58.36 tbd 1,164 1,223 tbd tbd tbd tbd -0.033 tbd HED-CDCA1C:4,HED-BCS:3,HED-OMW:4,HED-SUPC:3,HED-COAMR:5,HED-COAPS:3,HED-COL:3,HED-MPR:4,HED-CDCEYE:4 3.727 0.218
33 6 10 7 10 1 60.12 H5928 34,562 Blue Shield of California California Physicians Service CA-100.0% Medium Well Established Yes 34,562 60.12 2009 2011 2011 3.53.5,3.5,33.5 3.34 3.01 3.6 3.29 60.84 tbd 1,189 1,250 tbd tbd tbd tbd 0.106 tbd HED-CDCEYE:4,HED-OMW:4,HED-SUPC:3,HED-BCS:4,HED-MPR:3,HED-COL:4,HED-CDCA1C:3 3.444 0.011
33 8 9 10 6 1 41.39 H9003 103,532 Kaiser Permanente Kaiser Foundation Health Plan Inc. OR-71.8%,WA-28.2% Large Well Established Yes 103,532 41.39 2009 2011 2009 4.55,5,43.5 3.35 4.07 4.67 4.61 83.99 tbd 1,082 1,166 tbd tbd tbd tbd 0.048 tbd HED-CDCEYE:5,HED-COL:5,HED-SUPC:4,HED-MPR:5,HED-BCS:5,HED-OMW:5,HED-CDCA1C:4 4.556 1.122
33 9 10 9 5 1 36.77 H9431 9,843 Aetna Medicare CVS Health Corporation NM-57.1%,OR-24.8%,ID-13.1%,ND-5.0% Small 4+ Yrs Old Yes 9,843 36.77 2019 2022 2020 No DataNo Data,3.5,33 3.03 3.21 3.34 3.96 70.09 tbd 1,043 1,113 tbd tbd tbd tbd -0.059 tbd HED-SUPC:3,HED-CDCEYE:4,HED-OMW:4,HED-MPR:5,HED-BCS:3,HED-COL:3,HED-CDCA1C:4 3.778 0.344
plan_screener_reports
plan_screener
Star Rating Trend