Aetna shines in Star Ratings with 88 percent of Medicare Advantage members in 4-star plans or higher for 2025

Exceptional service results in highest-ever Aetna member experience score 

WOONSOCKET, R.I., Oct. 10, 2024 /PRNewswire/ -- Aetna®, a CVS Health® company (NYSE: CVS), announced today that 88 percent of its Medicare Advantage (MA) members are in 2025 Medicare Advantage Prescription Drug (MAPD) plans that are rated 4 stars or higher (out of 5 stars) by the Centers for Medicare & Medicaid Services (CMS). Additionally, more than two out of three (68 percent) Aetna Medicare Advantage members are in a 4.5-star plan for 2025.

"Our excellence in 2025 Star Ratings reflects our efforts to continuously improve how we serve our Medicare Advantage members and help keep them healthy," said CVS Health President and CEO Karen S. Lynch. "Our commitment to outstanding service resulted in our highest-ever member experience score since CMS launched the Quality Bonus Stars Program in 2012. These results are a testament to the dedication of our team across CVS Health and focus on what matters most to the health and experience of our members."

Our Star Ratings success includes high-quality performance of our largest MA contracts, covering approximately 2.9 million members:

• Our Aetna National Group PPO (H5522) with 1.4 million members again achieved 4.5 stars, extending its streak to 13 years with 4+ star performance.
• Our Aetna National Individual PPO (H5521) with 1.1 million members achieved 4.5 stars, improving half a star, driven by strong performance across all domains.
• Our Aetna Pennsylvania HMO (H3959) with 235K members earned 4.5 stars and achieved a near-perfect 5-star level of performance (4.85 domain average) in the Member Experience (CAHPS) domain.
• Our Aetna Florida HMO (H1609) with 155K members earned 4 stars, showing a notable improvement in the CAHPS domain and high scores in the clinical Stars measures.

Across our Medicare Advantage business, we achieved 4+ star performance¹ among the four key domains measured by CMS: Operations, Member Experience (CAHPS), Drug Safety and Accuracy of Drug Pricing, and Healthcare Effectiveness Data and Information Set (HEDIS).    

Aetna also delivered impressive performance across a wide and diverse range of individual Star measures. Our top-performing measures (by enrollment weighted average performance) include:  

• Care for Older Adults – Medication Review (5.0)
• Part C Call Center Monitoring (4.99)
• Medication Reconciliation Post-Discharge (4.98)
• Diabetes Care – Blood Sugar Control (4.97)
• Part D Quality Improvement (4.80)
• Care Coordination (4.53)
• Getting Needed Prescription Drugs (4.38)
• Rating of Drug Plan (4.35)
• Complaints about the Drug Plan (4.30)
• Complaints about the Health Plan (4.30)
• Rating of Health Care Quality (4.23)
• Getting Appointments and Care Quickly (4.18)
• Medication Adherence for Hypertension (4.15)
• Care for Older Adults – Pain Assessment (4.13)
• Medication Therapy Management Completion Rate (4.10)
• Rating of Health Plan (4.08)

Aetna 4.5-Star Rated Contracts

• H5522 Aetna Life Insurance Company (PPO)
• H5521 Aetna Life Insurance Company (PPO)
• H3959 Aetna Health Inc. (PA) (HMO)
• H2663 Coventry Health Care of Missouri, Inc. (HMO)
• H5325 Coventry Health Care of Kansas, Inc. (HMO)
• H1692 Coventry Health Care of West Virginia, Inc. (HMO)
• H3597 Aetna Health Inc. (ME) (HMO)
• H7149 Aetna Health Inc. (PA) (HMO)
• H5302 Aetna Health Inc. (GA) (HMO)
• H5593 Aetna Health of Iowa Inc. (HMO)
• H3928 Aetna Health Inc. (LA) (HMO)
• R6694 Aetna Life Insurance Company (PPO)

Aetna 4-Star Rated Contracts

• H1609 Aetna Health Inc. (FL) (HMO)
• H1608 Coventry Health and Life Insurance Company (PPO)
• H2293 SilverScript Insurance Company (PPO)
• H7301 Coventry Health Care of Illinois, Inc. (PPO)
• H0628 Aetna Health of Ohio Inc. (HMO)
• H3146 Aetna Better Health Inc. (GA) (HMO)
• H3239 Aetna Better Health, Inc. (LA) (HMO)
• H3152 Aetna Health Inc. (NJ) (HMO)
• H3219 Allina Health and Aetna Insurance Company (PPO)
• H5793 Aetna Health Inc. (CT) (HMO)
• H4523 Aetna Health Inc. (TX) (HMO)
• H8332 Aetna Better Health of Kansas Inc. (HMO)
• H1109 Aetna Health Inc. (GA) (HMO)

Every year, Medicare evaluates plans based on a 5-star rating system. The Star Ratings are posted at Medicare.gov. Visit AetnaMedicare.com to learn more about the 2025 Aetna Medicare plans. Or call 1-844-588-0041 (TTY: 711), 7 days a week, 8 AM to 8 PM. The Medicare Annual Enrollment Period runs from October 15 through December 7, 2024. A licensed agent may answer your call.

NOTE: Information in this release is based on 2025 Star Ratings data published by CMS on October 10, 2024, and MA and MAPD enrollment as of September 2024.

¹Enrollment weighted domain average across all Aetna MA contracts receiving a Star Rating.

About CVS Health
CVS Health® is the leading health solutions company, delivering care like no one else can. We reach more people and improve the health of communities across America through our local presence, digital channels and over 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that's managing chronic diseases, staying compliant with their medications or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day. Follow @CVSHealth on social media.

About Aetna
Aetna, a CVS Health business, serves more than 36 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental and behavioral health plans, and medical management capabilities, Medicaid health care management services, workers' compensation administrative services and health information technology products and services. Aetna's customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, visit Aetna.com.

Aetna Medicare is a HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. 

©2024 Aetna Inc.
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SOURCE CVS Health