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Member Research & Reports

Member Research & Reports

BU Study Finds Nonprofit Medicare Advantage Plans Rated Higher Than For-Profit Ones

Larger, older, and nonprofit Medicare Advantage plans are more likely to receive higher quality ratings, a new study from Boston University School of Public Health (BUSPH) shows.

The results, published in the Annals of Internal Medicine, found that quality varied strongly between nonprofit and for-profit plans, which may indicate the need for additional oversight by the Centers for Medicare and Medicaid Services (CMS).

CMS rates Medicare Advantage plans on a scale ranging from one to five stars, with one star indicating poor performance and five stars reserved for plans deemed excellent. The rating system, in use since 2008, is based on a variety of indicators that include processes of care, health outcomes, access to care, and beneficiary satisfaction.

About 55 percent of nonprofit plans received star ratings of four or higher, while just 15 percent of for-profit plans achieved the same quality ratings.

“We feel that CMS isn’t giving enough attention to this issue,” said study co-author Dr. Lewis Kazis, professor of health policy and management at BUSPH. “As a consumer you might want to ask the question when looking at a plan—is a plan for-profit or is it nonprofit?”

To read more about the study, go to: