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MBMG Holding LLC, operator of Clinical Care Medical Centers in Florida, has filed for Chapter 11 bankruptcy, citing financial struggles due to Medicaid and Medicare changes, rising costs post-COVID-19, and substantial debt from its acquisition by Sun Capital Partners. The company plans to sell its 26 facilities to a Humana affiliate for $45 million, pending court and regulatory approvals. KKR has agreed to provide $10 million in financing to support the bankruptcy process.
The 2025 Medicare Advantage star ratings reveal a decline for major insurers like UnitedHealth and Humana, with Humana experiencing the largest drop at 0.74 stars. In contrast, insurtechs like Clover Health and Alignment Healthcare saw significant improvements, with Clover achieving a 4-star rating for its PPO offering. As open enrollment approaches, Humana is contesting its scores, while UnitedHealth is pursuing legal action over a call center issue.
Medicare Advantage (MA) star ratings have declined for the third consecutive year, with only 40% of plans achieving four stars or higher in 2025, down from 68% in 2022. The average star rating is expected to drop from 4.07 to 3.92, influenced by increased cut points and changes in performance measures. Insurers are expressing frustration with the ratings, with some, like Humana and UnitedHealth, taking action against the Centers for Medicare & Medicaid Services.
UnitedHealthcare has filed a lawsuit against the Centers for Medicare and Medicaid Services (CMS) over a downgrade in its Medicare Advantage star ratings, claiming the decision was based on a single customer service interaction deemed "arbitrary and capricious." The insurer argues that this downgrade could significantly impact its enrollment and financial performance during the critical open enrollment period starting October 15. Other insurers, like Humana, are also facing challenges with star ratings, as they report declines in high-rated plan memberships.
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