CVS Health's Aetna Says Strong Medicare Star Ratings Boost Confidence in Return to Appropriate Margins

CVS Health Corp. (NYSE:CVS) said Thursday that more than 69% of its Aetna subsidiary’s Medicare Advantage members are enrolled in 2027 plans rated four stars or higher by the Centers for Medicare & Medicaid Services (CMS).

The results place Aetna among the highest-performing large, publicly traded Medicare Advantage insurers for the third consecutive year, according to the company.

Aetna President Steve Nelson said the ratings reflect the insurer’s strong market position and continued focus on clinical quality and operational excellence.

Nelson added that disciplined execution and improvements in member care give Aetna confidence in its ability to restore appropriate profit margins while delivering better health outcomes and customer experiences.

Excellence in Clinical Quality

Aetna earned 4.77 out of five stars for its plan all-cause readmissions measure, reflecting its focus on care coordination and transitions between care settings.

Keeping individuals out of the hospital remains a primary indicator of overall healthcare quality.

Furthermore, the insurer earned a perfect 5.00 score for medication reviews among older adults and a 4.03 for functional status assessments. These ratings emphasize the vital support Aetna provides to help members manage their wellness and maintain independence.

The company also posted marks for early disease detection, earning a 4.19 for colorectal cancer screenings and a 4.07 for breast cancer screenings.

CVS Health Delivering Premium Member Experience

Beyond clinical care, Aetna excelled in customer support and member satisfaction.

Aetna earned 4.29 stars for its drug plan complaints measure, reflecting favorable performance on member complaints.

Enrollees reported positive interactions regarding healthcare access. Aetna achieved a 4.04 for customer service, a 4.07 for securing necessary prescription medications, and a 3.89 for accessing required care.

Aetna also received 4.22 stars for its health care quality measure, reflecting members’ experiences with their health care providers.

Strong Operational Performance

Aetna also posted strong results across several administrative and customer support measures. The insurer recorded a near-perfect 4.99 for its call center interpreter and teletypewriter availability.

Additionally, the company scored well on administrative fairness, logging a 4.08 for reviewing appeals, a 4.01 for prompt appeal decisions, and a 4.01 for drug price precision.

CVS Price Action: CVS Health shares were up 0.27% at $88.04 at the time of publication on Friday, according to Benzinga Pro data.

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