Overall Star Ratings Declined for Multiple Medicare Advantage Insurers

 

November 9, 2023

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. For this year’s scores, CMS continued to make multiple changes to the methodology used to determine the star ratings. Among them were changes to the way CMS handled outlier data and data integrity issues for disaster-affected contracts. It also increased the weight of the Part C controlling blood pressure measure, from 1 to 3, and added three new Part C measures with a weight of 1, including: a re-specified plan all-cause readmissions measure; a transitions of care measure; and a follow-up after emergency department visit for people with multiple high-risk chronic conditions measure.[1] These changes led to significant declines in the number of contracts rated 4 stars or higher for 2024. For this analysis, Mark Farrah Associates (MFA) used Medicare Benefits Analyzer™, a product that helps simplify analysis of the Medicare.gov data, and includes details on the Star Ratings metrics and enrollment for companies competing in Medicare Advantage (MA). This brief presents a snapshot of the 2022 to 2024 MA Star Ratings for Part C, overall. 

Medicare Star Ratings

All health and drug plan ratings are reported at the contract level. MA plans with prescription drug coverage (MA-PD) contracts are rated on up to 40 unique quality and performance measures; MA-only contracts (without prescription drug coverage) are rated on up to 30 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 from Medicare Benefits Analyzer, a total of 798 MA contracts, made up of 5,805 distinct MA plan offerings, are in the market lineup for 2024. This includes MA-only, MA-PD plans, Medicare/Medicaid plans (MMPs), and Special Needs Plans (SNPs) and, for this analysis, excludes PDP contracts and MA plans offered by employers.

 

 

  • A total of 31 active MA contracts received a 5-star rating for the 2024 rating year, down from the 57 contracts that received this distinguished rating for 2023. For 2024, 3.9% of all MA contracts were rated as 5-Stars, down from 7.0% last year, and over 9.4% of all MA contracts for 2022.
     
  • For 2024, 20 of the 31 MA 5-star rated contracts included at least one Special Needs Plan (SNP) which was active during the rating contract year and still available for 2024.
     
  • In the most recent rating year, 17 separate parent companies received a 5-Star rating. UnitedHealth Group has the most contracts, with 8 receiving this accolade, 6 include SNPs; followed by Humana with 4 contracts, two include SNPs. For 2023, 33 parent companies had 5-Star contracts. UnitedHealth Group had the most contracts with 9, followed by Kaiser Foundation Health Plan Group with 5 contracts.
     
  • The number of contracts not rated (0-Stars) dropped from 306 to 253, between 2023 and 2024. CMS requires plans to be in the market for three years and have a certain amount of data to be rated.
     
  • There were 71 newly rated MA plans for 2024; for 2023, there were 55 newly rated MA contracts.
     
  • Forty-eight contracts were withdrawn from the market for 2024, including four 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. Fifty-eight contracts were withdrawn last year.

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 of the new benefits data being posted by CMS, usually during the first and second weeks of October, with periodic data refreshes. Interactive web tables present: Medicare Advantage (MA) and Prescription Drug Plan (PDP) benefits, premiums, co-pays, prescription (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 pharmacy 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, downloadable to Excel. Medicare Benefits Analyzer™ subscriptions all include access to Medicare Business Online™ for the latest MA & PDP 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 2024 Part C & D Star Ratings Technical Notes Updated – 09/29/2023

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