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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 (2022)
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
  2019-2023 Star Ratings
Last 4 year's star ratings
  Star Average 2023
Calculated Star Rating w/out adjustments
  Star Average 2022
Calculated Star Rating for 1 Year Ago
  Star Average 2021
Calculated Star Rating for 2 Years Ago For Previous Previous year's Star Average : Sum(Avg Star * star_wt) / sum(star_wt)
  Star Average 2019
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
  2023 Baseline Benchmark
Weighted average CMS county benchmark without bonus
  2023 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
30 10 10 10 0 H4835 21,091 Aetna Medicare CVS Health Corporation AZ-99.8% Medium New Plan No 21,407 2020 2022 2020 No Data,No Data,3 3.27 3.13 5 0 88.73 tbd 1,000 1,089 tbd tbd tbd tbd -0.108 tbd HED-CDCEYE:5,HED-CDCNPH:4,HED-COL:4,HED-MPR:5,HED-OMW:4,HED-SUPC:3,HED-BCS:4,HED-CDCA1C:5 4.4 0.71
29 10 10 9 0 H0672 4,596 Cigna CIGNA CO-70.7%,NM-23.2%,OH-6.1% Small Parent Org Established No 4,628 2020 2023 2009 No Data,No Data,No Data 2.55 3.5 5 0 71.95 tbd 1,012 1,084 tbd tbd tbd tbd -0.063 tbd HED-CDCEYE:3,HED-CDCNPH:5,HED-COL:2,HED-MPR:4,HED-CDCA1C:4 3.714 -0.157
29 9 10 10 0 H5859 14,765 CareOregon Advantage CareOregon Inc. OR-100.0% Medium Well Established No 15,191 2009 2011 2009 3.5,3.5,4 3.19 3.81 3.3 3.41 82.73 tbd 1,015 1,098 tbd tbd tbd tbd 0.005 tbd HED-CDCEYE:3,HED-CDCNPH:2,HED-COAMR:4,HED-COAPS:4,HED-COL:3,HED-MPR:5,HED-OMW:2,HED-SUPC:3,HED-BCS:2,HED-CDCA1C:4 3.333 -0.467
29 10 10 9 0 H3748 32,399 Aetna Medicare CVS Health Corporation WA-100.0% Medium New Plan No 32,563 2020 2022 2020 No Data,No Data,3.5 3.15 3.67 5 0 73.4 tbd 1,012 1,086 tbd tbd tbd tbd -0.115 tbd HED-BCS:4,HED-CDCA1C:5,HED-CDCEYE:4,HED-CDCNPH:3,HED-COL:4,HED-MPR:5,HED-OMW:4,HED-SUPC:4 4.3 0.61
29 9 10 10 0 H0351 25,851 Wellcare by Allwell Centene Corporation AZ-100.0% Medium Well Established No 25,798 2009 2011 2009 3,3,3 2.49 3.1 2.89 2.86 78.449 tbd 996 1,075 tbd tbd tbd tbd -0.003 tbd HED-CDCEYE:4,HED-CDCNPH:4,HED-COAMR:5,HED-COAPS:5,HED-COL:4,HED-MPR:3,HED-OMW:5,HED-SUPC:2,HED-BCS:3,HED-CDCA1C:3 3.667 -0.133
28 10 10 8 0 H4982 27,261 Aetna Medicare CVS Health Corporation CA-100.0% Medium New Plan No 27,444 2020 2022 2020 No Data,No Data,3 2.81 3.19 5 0 61.24 tbd 1,057 1,118 tbd tbd tbd tbd -0.175 tbd HED-CDCEYE:5,HED-CDCNPH:4,HED-COAMR:5,HED-COAPS:4,HED-COL:4,HED-MPR:3,HED-OMW:4,HED-SUPC:2,HED-BCS:5,HED-CDCA1C:5 4.25 0.45
28 10 10 8 0 H4346 15,754 Anthem Blue Cross and Blue Shield Elevance Health Inc. NV-71.3%,CO-28.4% Medium Well Established No 15,473 2010 2012 2023 3.5,3,3.5 2.54 3.33 3.11 3.28 61.44 tbd 1,081 1,142 tbd tbd tbd tbd -0.107 tbd HED-BCS:3,HED-CDCA1C:3,HED-CDCEYE:4,HED-CDCNPH:4,HED-COAMR:5,HED-COAPS:5,HED-COL:3,HED-MPR:3,HED-OMW:4,HED-SUPC:3 3.583 -0.217
28 10 9 9 0 H2463 2,742 Humana Humana Inc. AZ-100.0% Small 4+ Yrs Old No 2,691 2019 2022 2009 No Data,No Data,3.5 3 3.61 4 5 76.162 tbd 991 1,067 tbd tbd tbd tbd -0.139 tbd HED-CDCEYE:4,HED-CDCNPH:4,HED-COL:4,HED-MPR:5,HED-SUPC:3,HED-BCS:3,HED-CDCA1C:5 4.222 0.411
27 8 9 10 0 H5580 15,584 Mercy Care Advantage Mercy Care AZ-100.0% Medium Well Established No 15,631 2009 2011 2019 3.5,3,3.5 2.88 3.25 2.87 3.24 99.006 tbd 997 1,096 tbd tbd tbd tbd 0.041 tbd HED-BCS:2,HED-CDCA1C:4,HED-CDCEYE:4,HED-CDCNPH:4,HED-COAMR:4,HED-COAPS:4,HED-COL:2,HED-MPR:3,HED-OMW:1,HED-SUPC:3 3.25 -0.55
27 10 8 9 0 H1353 6,836 Wellcare Centene Corporation WA-100.0% Small Parent Org Established No 7,202 2020 2023 2009 No Data,No Data,No Data 2.42 3.14 5 0 66.07 tbd 1,015 1,081 tbd tbd tbd tbd -0.351 tbd HED-CDCA1C:3,HED-CDCEYE:3,HED-CDCNPH:3,HED-COAMR:3,HED-COAPS:3,HED-COL:2,HED-MPR:3,HED-SUPC:3 2.9 -1.03
27 8 9 10 0 H9003 101,906 Kaiser Permanente Kaiser Foundation Health Plan Inc. OR-71.5%,WA-28.5% Large Well Established No 102,460 2009 2011 2009 4.5,5,5 4.06 4.67 4.61 4.37 80.35 tbd 1,011 1,091 tbd tbd tbd tbd 0.048 tbd HED-BCS:5,HED-CDCA1C:5,HED-CDCEYE:5,HED-CDCNPH:4,HED-COL:5,HED-MPR:5,HED-OMW:5,HED-SUPC:4 4.8 1.11
27 9 8 10 0 H5746 3,206 Amerigroup Community Care of New Mexico Elevance Health Inc. NM-100.0% Small Well Established No 3,188 2009 2012 2023 3,3,3 2.21 2.83 2.89 3 76.681 tbd 928 1,005 tbd tbd tbd tbd 0.009 tbd HED-CDCEYE:2,HED-CDCNPH:2,HED-COL:2,HED-MPR:2,HED-SUPC:3,HED-BCS:2,HED-CDCA1C:3 2.444 -1.367
27 10 9 8 0 H9431 17,626 Aetna Medicare CVS Health Corporation NM-34.7%,NH-28.7%,OR-14.4%,RI-13.9%,ID-5.6%, 1 others - 2.6% Medium 4+ Yrs Old No 18,088 2019 2022 2020 No Data,No Data,3.5 3.22 3.34 3.96 5 62.615 tbd 996 1,059 tbd tbd tbd tbd -0.112 tbd HED-CDCEYE:4,HED-CDCNPH:3,HED-COL:3,HED-MPR:5,HED-OMW:4,HED-SUPC:4,HED-BCS:3,HED-CDCA1C:4 3.8 0.11
27 10 8 9 0 H2056 13,339 Aetna Medicare CVS Health Corporation OR-74.4%,ID-25.6% Medium New Plan No 13,744 2020 2022 2020 No Data,No Data,3 3.03 3.09 5 0 69.45 tbd 1,021 1,090 tbd tbd tbd tbd -0.334 tbd HED-CDCEYE:5,HED-CDCNPH:3,HED-COL:3,HED-MPR:5,HED-SUPC:1,HED-BCS:3,HED-CDCA1C:4 3.556 -0.256
27 9 10 8 0 H0544 143,444 Anthem Blue Cross Elevance Health Inc. CA-99.9% Large Well Established No 145,382 2009 2011 2023 4,3.5,3.5 2.96 3.57 3.45 3.52 61.7 tbd 1,072 1,134 tbd tbd tbd tbd -0.033 tbd HED-CDCEYE:4,HED-CDCNPH:5,HED-COAMR:5,HED-COAPS:4,HED-COL:3,HED-MPR:4,HED-OMW:3,HED-SUPC:3,HED-BCS:4,HED-CDCA1C:5 4.167 0.367
26 10 7 9 0 H5628 16,635 Molina Healthcare of Utah & Idaho Molina Healthcare Inc. UT-64.0%,ID-35.9% Medium Well Established No 16,808 2009 2011 2009 3.5,3.5,3.5 2.93 3.34 3.33 3.22 68.78 tbd 1,015 1,084 tbd tbd tbd tbd -0.186 tbd HED-BCS:2,HED-CDCA1C:3,HED-CDCEYE:3,HED-CDCNPH:2,HED-COAMR:3,HED-COAPS:3,HED-COL:3,HED-MPR:2,HED-OMW:1,HED-SUPC:3 2.583 -1.217
26 10 8 8 0 H0524 1,314,779 Kaiser Permanente Kaiser Foundation Health Plan Inc. CA-99.9% Large Well Established No 1,323,977 2009 2011 2009 5,5,5 4.38 4.67 4.81 4.5 59.76 tbd 1,068 1,128 tbd tbd tbd tbd -0.079 tbd HED-CDCEYE:5,HED-CDCNPH:5,HED-COAMR:5,HED-COAPS:5,HED-COL:5,HED-MPR:5,HED-OMW:5,HED-SUPC:5,HED-BCS:5,HED-CDCA1C:5 5 1.2
26 10 9 7 0 H7621 9,771 Humana Humana Inc. CA-74.6%,MO-16.4%,KS-9.0% Small 4+ Yrs Old No 9,809 2019 2022 2009 No Data,No Data,3.5 3.04 3.56 3.88 5 57.45 tbd 1,037 1,094 tbd tbd tbd tbd -0.139 tbd HED-BCS:4,HED-CDCA1C:4,HED-CDCEYE:4,HED-CDCNPH:5,HED-COL:4,HED-MPR:5,HED-SUPC:3 4.111 0.3
25 7 8 10 0 H9047 61,702 Providence Medicare Advantage Plans Providence Health & Services OR-95.5%,WA-4.5% Large Well Established No 61,832 2009 2011 2012 4.5,4.5,5 3.76 4.29 4.01 4.18 84.51 tbd 1,016 1,100 tbd tbd tbd tbd 0.062 tbd HED-CDCEYE:5,HED-CDCNPH:4,HED-COAMR:5,HED-COAPS:5,HED-COL:5,HED-MPR:5,HED-OMW:4,HED-SUPC:4,HED-BCS:5,HED-CDCA1C:5 4.75 0.95
25 10 6 9 0 H9460 1,635 Cigna CIGNA MO-61.3%,KS-38.7% Small Established No 1,513 2016 2018 2009 3,3,3.5 3.06 3.29 3.04 3 66.96 tbd 1,022 1,089 tbd tbd tbd tbd -0.058 tbd HED-BCS:3,HED-CDCA1C:4,HED-CDCEYE:3,HED-CDCNPH:5,HED-COL:3,HED-MPR:4,HED-SUPC:3 3.667 -0.144
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Star Rating Trend