November 9, 2023
Will Lower 2024 Star Ratings Move the Needle for Medicare Advantage Members?
The short answer is NO for most members enrolled in Medicare Advantage+Part D plans. Why?
- Without knowing ‘inside the game’ rating details, Medicare Advantage plan members stand little chance of making informed decisions based on health plan or Part D Star ratings;
- There is zero incentive for Medicare Advantage plans to disclose to current members and prospects why 2024 ratings are lower than their previous 2023 ratings;
- Locating each plan's Star rating details on Medicare.gov 2024 Medicare Plan Finder requires scrolling to the end of each plan's benefits summary and then provides only minimum explanation for the health plan and Part D Star ratings;
- The 2024 Medicare & You publication only notes CAHPS "member rating" scores, e.g. 87%, with little explanation versus Star ratings for local Medicare Advantage and Part D plans;
- Like other consumer-facing industry performance ratings -- banks, investments, insurance, health providers -- past performance is not a guarantee of future performance.
- Members' tendency is to avoid the hassles involved with switching plans unless cost-sharing or provider access changes will impact them significantly.
The impact and usefulness of Star ratings would likely increase with improved transparency and disclosure by both CMS and plans alike. For example:
- CMS should explain that 2024 Star ratings represent a 'rear-view' or look-back at quality/outcome measures from 2021-2022 plan activity;
- Some of the downward trend for Star ratings can be attributed to adjustments in the CMS data methodology – newer quality measures replacing retired measures and different weighting factors for selected measures;
- Star ratings determine the allocation of bonus payments to higher-rated plans or future payment reductions to under-performing plans that could impact the availability of supplemental benefits and services, Part B givebacks, provider access.
Personal note: I have been highly satisfied since disenrolling from a 4 Star plan and enrolling in a 3.5 Star plan almost 7 years ago when I could have selected higher rated options. My plan just improved to 4 Star for 2024, yet I do not know what occurred to improve the overall Star rating.
Bottomline: Year-over-year Star rating changes alone provide little incentive or motivation for Medicare Advantage members to switch plans. 'Age-ins' and 'move-ins' may find Star ratings useful for filtering overwhelming number of plan options down to a manageable number of higher-rated plans to consider for enrollment.
Source: "2024 Star Rating Analysis: The Story Lies Beyond the Outliers", HealthScape Advisors, November 2, 2023.
HealthMetrix Research Inc.
Alan Mittermaier, President
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