Nationally, more than a quarter of Medicare’s rated prescription drug plans that will be available to seniors in 2012 get poor ratings from federal officials. And in the Washington metro area, 36 percent rate unacceptably low, according to an analysis of Medicare data.
The Centers for Medicare and Medicaid Services is putting these plans on notice that, unless they take steps to improve their performance over the next few years, they face expulsion from Medicare.
CMS this month revised the way it rates Medicare drug plans to focus more on quality, and many plans’ ratings fell from 2011 to 2012. The criteria changed to stress clinical outcomes, such as whether a patient takes his medication the way he is supposed to, in addition to process measures, such as how long a patient is kept on hold when calling the plan. In judging 2012 plans, CMS for the first time considered whether patients kept up with medications for diabetes, hypertension and cholesterol, and it also considered complaints lodged against plans, and the numbers of people who choose to leave plans.
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