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Declines in Medicare Advantage Part C Overall Star Ratings for Many Insurers

 

October 31, 2022

The Centers for Medicare & Medicaid Services (CMS) created the Part C & D Star Ratings to provide quality and performance information to Medicare beneficiaries to assist them in choosing their health and drug services during the annual fall open enrollment period. The Star Ratings system also rewards higher-performing plans. As expected, CMS made several changes to the methodology used to determine the star ratings between 2022 and 2023. Among them were increases in the weights of the patient experience/complaints and access measures, from a weight of 2 to a weight of 4.[1] These changes led to significant declines in the number of contracts rated 3.5 stars or higher for 2023. Medicare Benefits Analyzer™, a Mark Farrah Associates’ database, helps simplify analysis of the Medicare.gov data, including details on the Star Ratings metrics for companies competing in this segment. This brief presents a snapshot of the 2021 to 2023 Medicare Advantage (MA) Star Ratings for Part C Overall. 

Medicare Star Ratings

MA plans with prescription drug coverage (MA-PD) contracts are rated on up to 38 unique quality and performance measures; MA-only contracts (without prescription drug coverage) are rated on up to 28 measures; and stand-alone Prescription Drug Plan (PDP) contracts are rated on up to 12 measures. The contract (and plans within the contract) are rated on a 1 to 5-star scale, with 1 star for poor performance and 5 stars for excellent performance. Based on an analysis of CMS Star Ratings information in Medicare Benefits Analyzer, a total of 794 MA contracts, made up of 5,764 distinct Medicare Advantage (MA) plan offerings, are in the market lineup for 2023. This includes MA-only, MA-PD plans, Medicare/Medicaid plans (MMPs), and Special Needs Plans (SNPs) and excludes PDP contracts.

 

 

  • A total of 56 active MA contracts received a 5-star rating in 2023, down from the 74 contracts that received this distinguished rating in 2022. In 2023, 7.0% of all MA contracts were rated as 5-Stars, down from over 9.4% of all MA contracts in 2022.
     
  • In 2023, 33 separate parent companies received a 5-Star rating, UnitedHealth Group has the most contracts, with 9 receiving this accolade, followed by Kaiser Foundation Health Plan Group with 5 contracts. In 2022, 41 parent companies had 5-Star contracts, UnitedHealth Group had the most contracts with 13, followed by Kaiser Foundation Health Plan Group with 7 contracts.
     
  • The number of contracts not rated (0-Stars) dropped from 316 to 293, between 2022 to 2023. CMS requires plans to be in the market for three years and have a certain amount of data to be rated.
     
  • There were 55 newly rated MA plans in 2023; in 2022, there were 80 newly rated MA contracts.
     
  • Fifty-eight contracts were withdrawn from the market in 2023, including eight that were rated with four or more stars. Plans are considered withdrawn if they are not in the CMS’ Landscape files and do not have benefit data in Medicare.gov for the new year. Only nine contracts were withdrawn in 2022.

About Medicare Benefits Analyzer

Medicare Benefits Analyzer™ is a time-saving database for easy comparative analysis of Medicare premiums, co-pays and benefits. Benefits and Star Quality Ratings data is collected and organized from the Medicare.gov website and is updated within days the new benefits data is posted by CMS, usually during the first and second weeks of October, with periodic data refreshes. Interactive web tables present Medicare Advantage and PDP benefits, premiums, co-pays, Rx drug tiers & cost estimates by Plan, State & County; Star Quality Ratings data for measuring relative quality of MA & Part D plans; Drug tier costs by state presents standard and preferred cost-sharing by drug tier, purchase type and supply for all MA & Part D plans; Plan Finder profiles by state and plan with screen-shots of benefit details for easy look-up and reference; Medicare Advantage & PDP enrollment figures per plan and current Summary Star Ratings; and User-friendly web interface with easy-to-navigate tables and download to Excel; Medicare Benefits Analyzer™ subscriptions include access to Medicare Business Online™ for the latest enrollment data.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health PLUS, and Health Plans USA™. For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website or call 724-338-4100.

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[1] Medicare 2023 Part C & D Star Ratings Technical Notes Updated – 09/28/2022

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