Alignment Healthcare Announces Improvement of North Carolina and Nevada Medicare Advantage HMO 2024 Rating to 5 Stars, Highest Score from Medicare

Rhea-AI Summary

Alignment Healthcare announced that its Medicare Advantage HMO plans in North Carolina and Nevada have been recalculated to receive a 5-star rating by the Centers for Medicare and Medicaid Services (CMS) for 2024. This rating, the highest possible, reflects excellent performance in delivering high-quality care at lower costs. The improvement raises the contract's overall rating from 4.5 to 5 stars. More than 90% of Alignment's members are enrolled in plans rated 4 stars or higher, indicating consistent high-quality care. Alignment entered North Carolina in 2021 and earned a 5-star rating in the first year eligible, being one of only two MA HMO plans in the state to achieve this in 2023.

Positive

• Alignment Healthcare's Medicare Advantage HMO plans in North Carolina and Nevada received a 5-star rating from CMS for 2024.
• The rating reflects excellent performance in providing high-quality care at lower costs.
• The overall star rating improved from 4.5 to 5 stars.
• More than 90% of Alignment's members are enrolled in plans rated 4 stars or higher.

Negative

• None.

Insights

Financial Analyst

Alignment Healthcare's upgrade to a 5-star rating from the Centers for Medicare and Medicaid Services (CMS) is a remarkable milestone. A 5-star rating can significantly impact the company's Medicare Advantage (MA) enrollment since it serves as a benchmark for quality and cost efficiency. From a business perspective, this improvement can lead to increased revenue. Medicare plans with higher ratings attract more beneficiaries and are eligible for bonus payments from CMS. Additionally, the rating can enhance the company's reputation and competitive positioning in the market. Given that Alignment Healthcare now has more than 90% of its members enrolled in plans rated 4 stars or higher, the company demonstrates strong operational performance and customer satisfaction.

In the short term, this may result in a surge in stock price due to investor confidence in the company's service quality. In the long term, the improved rating could lead to sustained growth through higher enrollments and revenue streams. However, investors should also consider the competitive landscape and potential operational challenges in maintaining this high-performance level consistently.

Healthcare Policy Expert

From a healthcare policy perspective, Alignment Healthcare's 5-star rating underscores the effectiveness of their approach to Medicare Advantage plans. This rating reflects the company's ability to provide exceptional care and manage costs efficiently, which is important under the CMS evaluation criteria. The 5-star rating not only signifies clinical quality but also customer service and preventive care, critical areas for patient outcomes and satisfaction. The fact that Alignment achieved this rating within a relatively short period since entering North Carolina in 2021 is noteworthy and can be used to drive policy discussions around efficient healthcare delivery models.

The broader implications for stakeholders include potential policy support and funding opportunities, as high-performing MA plans often serve as models for broader healthcare reforms. This recognition will likely enhance Alignment's influence in industry discussions and policy-making forums.

Market Research Analyst

The improvement in Alignment Healthcare's star rating is an indicator of the company's strong market positioning and competitive edge. The Medicare Advantage market is becoming increasingly competitive and a 5-star rating can differentiate Alignment from competitors. This rating can be a powerful tool in marketing and sales, allowing the company to attract new members and retain existing ones. The emphasis on high-quality care and cost efficiency resonates well with the needs of the aging population and aligns with market trends towards value-based care.

For investors, this signifies Alignment's potential for market share growth and enhanced profitability. However, it is essential to monitor ongoing performance to ensure that the company can maintain these standards amidst industry pressures and regulatory changes.

ORANGE, Calif., June 24, 2024 (GLOBE NEWSWIRE) -- Alignment Healthcare, Inc. (NASDAQ: ALHC) today announced that the Centers for Medicare and Medicaid Services (CMS) recalculated the 2024 Star Rating of its H5296 Medicare Advantage (MA) HMO contract in North Carolina and Nevada, resulting in a 5-star out of a possible 5-star rating. Every year, CMS evaluates plans based on a 5-star rating, with 5 stars representing “excellent” performance.

“We’re pleased that CMS has revised the rating of our HMO contract in North Carolina and Nevada to achieve the highest possible score, recognizing excellent performance in delivering high-quality care at a lower cost,” said John Kao, founder and CEO, Alignment Health. “Our commitment to high-quality care extends to all our plans as more than 90% of Alignment members are enrolled in plans rated 4 stars or higher, meaning most of our members consistently receive a high-quality care experience.”

The improvement increases the contract’s overall star rating by 0.5 star, from 4.5 to 5 stars. According to CMS, the more stars a plan receives, the better the plan.

Alignment Health Plan, which entered North Carolina in 2021, earned 5 stars the first year it was eligible to be rated and was one of only two MA HMO plans in the state to achieve a 5-star rating in 2023.

For more information about Alignment Health Plan, visit www.alignmenthealthplan.com.

About Alignment Health
Alignment Health is championing a new path in senior care that empowers members to age well and live their most vibrant lives. A consumer brand name of Alignment Healthcare (NASDAQ: ALHC), Alignment Health offers more than 50 benefits-rich, value-driven Medicare Advantage plans that serve 53 counties across six states. The company partners with nationally recognized and trusted local providers to deliver coordinated care, powered by its customized care model, 24/7 concierge care team and purpose-built technology, AVA^®. Based in California, the company’s mission-focused team makes high-quality, low-cost care a reality for members every day. As it expands its offerings and grows its national footprint, Alignment upholds its core values of leading with a serving heart and putting the senior first. For more information, visit https://www.alignmenthealth.com/.

Investor Contact
Harrison Zhuo
hzhuo@ahcusa.com

Media Contact
Priya Shah
mPR, Inc. for Alignment Health
alignment@mpublicrelations.com

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FAQ

What is the new CMS star rating for Alignment Healthcare's Medicare Advantage HMO plans in North Carolina and Nevada for 2024?

The new CMS star rating for Alignment Healthcare's Medicare Advantage HMO plans in North Carolina and Nevada for 2024 is 5 stars.

How much did Alignment Healthcare's star rating improve for its Medicare Advantage HMO plans in North Carolina and Nevada?

Alignment Healthcare's star rating improved from 4.5 stars to 5 stars for its Medicare Advantage HMO plans in North Carolina and Nevada.

What percentage of Alignment Healthcare members are enrolled in plans rated 4 stars or higher?

More than 90% of Alignment Healthcare members are enrolled in plans rated 4 stars or higher.

When did Alignment Healthcare enter the North Carolina market?

Alignment Healthcare entered the North Carolina market in 2021.

How many Medicare Advantage HMO plans in North Carolina received a 5-star rating in 2023?

Only two Medicare Advantage HMO plans in North Carolina received a 5-star rating in 2023, including Alignment Healthcare.