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Annual Star Ratings Update Finds 81% of Beneficiaries with MA-PD Coverage Enrolled in Four or Five Star Plans

October 16, 2019

McDermott+Consulting

The Centers for Medicare and Medicaid Services (CMS) released their annual update of Medicare Part C and D Star Ratings. These ratings measure the quality of health and drug services received by beneficiaries enrolled in Medicare Advantage (MA) and Prescription Drug Plans (PDPs or Part D plans).

Data released by CMS shows that the percent of MA-PD contracts for plans with an overall rating of five stars increased from 3.72% (14 contracts) in 2019 to 4.99% (20 contracts). Approximately 52 percent of MA-PDs (210 contracts) that will be offered in 2020 earned 4 stars or higher for their 2020 overall rating. This is up from 172 contracts or 46% in 2019. Overall, 81% of beneficiaries with MA-PD coverage are enrolled in four or five star plans. It has been noted that CMS continues to have missing data for some rural areas.

Plans that earn four or more stars receive a 5% boost to their monthly per-member payments from Medicare. Medicare Payment Advisory Commission (MedPAC) has recommended significant modifications to the MA Star Ratings program.

The CMS fact sheet can be found here.

The CMS press release can be found here.

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For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459/smadhani@mcdermottplus.com or Mara McDermott at 202-204-1462/mmcdermott@mcdermottplus.com.

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