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Medicare Advantage Star Ratings Fall as Pandemic Provisions End

Analysis  |  By Jay Asser  
   October 07, 2022

CMS released the 2023 star ratings for Medicare Advantage and Part D plans, with the average rating at 4.15.

The average star rating and number of five-star contracts for Medicare Advantage (MA) plans declined for 2023, CMS announced.

The agency released the annual star ratings for MA and Part D plans to help potential beneficiaries compare plans ahead of the annual enrollment period, which begins on October 15. The ratings are on a one-to-five scale and determined on up to 38 unique quality and performance measures.

For 2023, the average rating across all plans is 4.15, down from last year's 4.37. The number of five-star contracts fell significantly from 74 in 2022 to 57 for the coming year.

Overall, there are 67 contracts that earned 4.5 stars (96 last year), 136 that earned four stars (152 last year), 116 that earned 3.5 stars (122 last year), and 90 that earned three stars (25 last year).

CMS stated that approximately 51% of MA plans that offer prescription drug coverage will have an overall rating of four stars or higher in 2023, while 72% of people currently in MA plans with drug coverage are enrolled in a plan that earned four or more stars.

The decline in ratings for 2023 isn't necessarily performance-based, as CMS adjusted its methodology to account for the COVID-19 pandemic no longer being at the height it was in recent years.

Guardrails were introduced for 2023 for all measures that have been in the Part C and D star rating program for more than three years, aside from the Consumer Assessment of Healthcare Providers and Systems survey and the Part C and Part D improvement measures.

America's Health Insurance Plans (AHIP) responded to the release of the ratings by backing MA's benefits to members.

Matt Eyles, AHIP president and CEO, stated: "The ongoing and continuing effects of factors such as COVID-19, along with recent CMS methodological and measurement changes, may have affected the 2023 Star Ratings results, which primarily relate to the 2021 performance year. Even so, the majority of Medicare Advantage enrollees are projected to be covered by high performing plans. AHIP and our member plans will continue to review the latest Star Ratings results and data closely to assess impacts."

MA advocacy group Better Medicare Alliance (BMA) also responded to the ratings by reiterating that MA beneficiaries will continue to receive quality, affordable care.

"CMS's announcement shows that, even amid the impact of the ongoing public health emergency and recent methodological changes, Medicare Advantage continues to deliver high-quality care for seniors. In fact, the number of 5, 4.5, and 4-star Medicare Advantage plan contracts is higher for 2023 than just two years ago, in 2021," said Mary Beth Donahue, BMA president and CEO.

Jay Asser is an associate editor for HealthLeaders.


KEY TAKEAWAYS

The average rating across all plans for 2023 is 4.15, down from last year's 4.37.

The number of five-star contracts fell significantly from 74 in 2022 to 57 for the coming year.

CMS adjusted its methodology to account for the COVID-19 pandemic no longer being at the height it was in recent years.


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