Aetna shines in Star Ratings with 88 percent of Medicare Advantage members in 4-star plans or higher for 2025
Aetna, a CVS Health company, announced that 88% of its Medicare Advantage members are in 2025 Medicare Advantage Prescription Drug (MAPD) plans rated 4 stars or higher by CMS. Notably, 68% of members are in 4.5-star plans. The company achieved its highest-ever member experience score since the Quality Bonus Stars Program began in 2012.
Key highlights include:
- Aetna National Group PPO (H5522) with 1.4 million members maintained 4.5 stars for the 13th consecutive year
- Aetna National Individual PPO (H5521) with 1.1 million members improved to 4.5 stars
- Aetna Pennsylvania HMO (H3959) with 235K members earned 4.5 stars with near-perfect performance in Member Experience
- Aetna Florida HMO (H1609) with 155K members earned 4 stars
Aetna achieved 4+ star performance across all four key domains measured by CMS and excelled in various individual Star measures.
Aetna, una compagnia di CVS Health, ha annunciato che l'88% dei suoi membri di Medicare Advantage sono iscritti ai piani per farmaci da prescrizione Medicare Advantage del 2025 (MAPD) valutati 4 stelle o superiori da CMS. È notevole che il 68% dei membri siano in piani da 4.5 stelle. L'azienda ha raggiunto il suo punteggio di esperienza del membro più alto di sempre da quando è iniziato il Programma dei Punti di Qualità nel 2012.
Tra i punti salienti si annoverano:
- Aetna National Group PPO (H5522) con 1,4 milioni di membri ha mantenuto 4.5 stelle per il 13° anno consecutivo
- Aetna National Individual PPO (H5521) con 1,1 milioni di membri è migliorato a 4.5 stelle
- Aetna Pennsylvania HMO (H3959) con 235K membri ha guadagnato 4.5 stelle con performance quasi perfette nell'Esperienza del Membro
- Aetna Florida HMO (H1609) con 155K membri ha guadagnato 4 stelle
Aetna ha ottenuto performance superiori a 4 stelle in tutti e quattro i principali ambiti misurati da CMS, eccellendo in vari indicatori individuali delle Stelle.
Aetna, una compañía de CVS Health, anunció que el 88% de sus miembros de Medicare Advantage están en planes de medicamentos recetados de Medicare Advantage de 2025 (MAPD) calificados con 4 estrellas o más por CMS. Es notable que el 68% de los miembros están en planes de 4.5 estrellas. La compañía logró su puntaje de experiencia del miembro más alto de la historia desde que comenzó el Programa de Estrellas de Bonificación de Calidad en 2012.
Los aspectos más destacados incluyen:
- Aetna National Group PPO (H5522) con 1.4 millones de miembros mantuvo 4.5 estrellas durante el 13º año consecutivo
- Aetna National Individual PPO (H5521) con 1.1 millones de miembros mejoró a 4.5 estrellas
- Aetna Pennsylvania HMO (H3959) con 235K miembros obtuvo 4.5 estrellas con un rendimiento casi perfecto en la Experiencia del Miembro
- Aetna Florida HMO (H1609) con 155K miembros obtuvo 4 estrellas
Aetna logró un rendimiento de 4+ estrellas en todos los cuatro dominios clave medidos por CMS y sobresalió en varias medidas individuales de estrellas.
Aetna, CVS Health의 자회사, 는 메디케어 어드밴티지 회원의 88%가 CMS에 의해 4성 이상으로 평가된 2025년 메디케어 어드밴티지 처방약(MAPD) 계획에 가입해 있다고 발표했습니다. 특히, 68%의 회원이 4.5성 계획에 가입해 있습니다. 이 회사는 2012년 품질 보너스 스타 프로그램이 시작된 이래로 가장 높은 회원 경험 점수를 달성했습니다.
주요 하이라이트는 다음과 같습니다:
- Aetna National Group PPO (H5522)는 140만 명의 회원을 보유하며 13년 연속 4.5성을 유지했습니다
- Aetna National Individual PPO (H5521)는 110만 명의 회원을 보유하고 있으며 4.5성으로 개선되었습니다
- Aetna Pennsylvania HMO (H3959)는 23만5천 명의 회원을 보유하며 회원 경험에서 거의 완벽한 성과를 달성하여 4.5성을 획득했습니다
- Aetna Florida HMO (H1609)는 15만5천 명의 회원을 보유하며 4성을 획득했습니다
Aetna는 CMS가 측정한 네 개의 주요 분야에서 4점 이상 성과를 달성했으며 다양한 개별 스타 지표에서 뛰어난 성과를 보였습니다.
Aetna, une entreprise de CVS Health, a annoncé que 88 % de ses membres Medicare Advantage sont inscrits dans des plans d'assurance médicaments Medicare Advantage de 2025 (MAPD) notés 4 étoiles ou plus par CMS. Notamment, 68 % des membres sont dans des plans à 4,5 étoiles. L'entreprise a atteint son meilleur score d'expérience membre jamais enregistré depuis le début du programme des étoiles de bonus qualité en 2012.
Les points clés incluent :
- Aetna National Group PPO (H5522) avec 1,4 million de membres a maintenu 4,5 étoiles pour la 13e année consécutive
- Aetna National Individual PPO (H5521) avec 1,1 million de membres a amélioré son classement à 4,5 étoiles
- Aetna Pennsylvania HMO (H3959) avec 235K membres a obtenu 4,5 étoiles avec une performance presque parfaite en expérience membre
- Aetna Florida HMO (H1609) avec 155K membres a obtenu 4 étoiles
Aetna a obtenu une performance de 4 étoiles ou plus dans les quatre principaux domaines mesurés par CMS et a excellé dans diverses mesures individuelles des étoiles.
Aetna, ein Unternehmen von CVS Health, gab bekannt, dass 88% seiner Mitglieder der Medicare Advantage in den für 2025 bewerteten Medicare Advantage-Rezeptarzneimittelplänen (MAPD) von CMS 4 Sterne oder mehr sind. Bemerkenswert ist, dass 68% der Mitglieder in 4,5-Sterne-Plänen eingeschrieben sind. Das Unternehmen erzielte den höchsten Mitgliedserfahrungswert, den es seit Beginn des Qualität-Bonus-Sterne-Programms im Jahr 2012 jemals erreicht hat.
Wichtige Höhepunkte sind:
- Aetna National Group PPO (H5522) mit 1,4 Millionen Mitgliedern hielt 13 Jahre in Folge 4,5 Sterne
- Aetna National Individual PPO (H5521) mit 1,1 Millionen Mitgliedern verbesserte sich auf 4,5 Sterne
- Aetna Pennsylvania HMO (H3959) mit 235K Mitgliedern erzielte 4,5 Sterne mit nahezu perfekter Leistung in der Mitgliedererfahrung
- Aetna Florida HMO (H1609) mit 155K Mitgliedern erzielte 4 Sterne
Aetna erreichte in allen vier von CMS gemessenen Schlüsselbereichen eine Leistung von über 4 Sternen und übertraf in verschiedenen individuellen Sternmessungen.
- 88% of Medicare Advantage members in 4-star or higher rated plans for 2025
- 68% of Medicare Advantage members in 4.5-star plans for 2025
- Highest-ever member experience score since 2012
- Aetna National Group PPO (1.4M members) maintained 4.5 stars for 13 consecutive years
- Aetna National Individual PPO (1.1M members) improved to 4.5 stars
- 4+ star performance across all four key domains measured by CMS
- None.
Insights
Aetna's strong performance in the 2025 Medicare Advantage Star Ratings is a significant positive indicator for CVS Health. With 88% of MA members in 4-star or higher plans and 68% in 4.5-star plans, this demonstrates exceptional quality and customer satisfaction. The improvement in ratings, particularly for large contracts covering 2.9 million members, suggests potential for increased enrollment and revenue growth.
The high scores in member experience and clinical measures indicate effective cost management and quality care delivery, which are important for profitability in the competitive MA market. This performance could lead to higher
Investors should view this as a strong indicator of Aetna's competitive position in the Medicare Advantage space, which is a key growth driver for CVS Health. The consistent high performance, with some plans maintaining 4+ stars for 13 years, suggests sustainable long-term value creation potential in this segment.
The impressive Star Ratings for Aetna's Medicare Advantage plans reflect a strategic alignment with CMS quality initiatives. This performance is particularly noteworthy given the increased scrutiny and evolving metrics in the MA program. The high scores across diverse measures - from medication management to member experience - indicate a holistic approach to healthcare delivery and customer service.
Of particular interest is the near-perfect score in the Member Experience (CAHPS) domain for the Pennsylvania HMO. This aligns with the industry-wide shift towards patient-centered care models and could position Aetna favorably as CMS continues to emphasize beneficiary satisfaction in its evaluation criteria.
The strong performance in medication-related measures (e.g., Medication Review, Reconciliation Post-Discharge) suggests effective integration of pharmacy services, likely leveraging CVS Health's PBM capabilities. This synergy could be a key differentiator in the increasingly competitive MA landscape.
Exceptional service results in highest-ever Aetna member experience score
"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.
Media contact
Ethan Slavin
860-273-6095
Ethan.Slavin@CVSHealth.com
Investor contact
Larry McGrath
800-201-0938
InvestorInfo@CVSHealth.com
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FAQ
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