2023 Medicare Advantage star ratings fall

Medicare Advantage plan star ratings have always been a farce, and you should not trust them. Most Medicare Advantage plans have four or five stars, and they still might offer poor quality care. Because of a change in the way the government weights different metrics, Medicare Advantage star ratings are falling a bit, reports Axios.

In 2023, 57 health insurers will offer Medicare Advantage plans with five-star ratings. This year, 74 health insurers offer Medicare Advantage plans with five-star ratings. The ratings are supposed to be based on quality measures, including consumer assessments, but the question is what goes into those measures and how are they weighted.

The government looks at how well the Medicare Advantage plans do at customer service, as well as keeping members healthy through preventive services and management of chronic conditions. The government also looks at member complaints. The Centers for Medicare and Medicaid Services (CMS) audits the data the Medicare Advantage plans report. But, Medicare Advantage plans can game the system to achieve higher ratings.

In fact, the federal government has never been able to assess the quality of care Medicare Advantage plans offer, overall, let alone individually. The Medicare Payment Advisory Commission (MedPac) repeatedly has said in its reports on Medicare Advantage that the health plans fail to disclose complete and accurate data, as required by law, to enable proper assessment of plan quality. Four and five-star rated Medicare Advantage plans could deliver poor health outcomes or otherwise jeopardize patient care, which might not be captured in the data CMS collects.

For sure, there is star-rating inflation. The average rating for all Medicare Advantage plans is more than four stars, 4.15 out of 5 stars. That’s down from 4.37 stars in 2022. Some plans, such as those offered by CVS Health and Centene, saw a big drop in star ratings and are now restricted in their ability to grow their enrollment. But, it does not appear that the the government notifies people already enrolled in those plans, let alone suggests they disenroll from them.

During the upcoming open enrollment season, if you opt for Medicare Advantage over traditional Medicare, don’t choose a Medicare Advantage plan by its stars or by the extra benefits they offer (which often are not what they appear to be.) Talk to your doctors and friends in the health plans you are considering, particularly people who have needed a lot of costly care. Find out whether they believe they have gotten the care they needed, without undue delays, and what they had to pay out of pocket.

During the pandemic, star ratings were weighted less heavily towards consumer satisfaction. Now, CMS is relying more heavily on patient survey data for its ratings, which is affecting ratings for some plans.

While consumer data only captures one aspect of quality, all Medicare Advantage plans are different in multiple ways. People in some plans face higher rates of delays and denials of care than in other plans. Several expert studies also show that many Medicare Advantage plans have disproportionate rates of disenrollment by people with costly and complex conditions.

Medicare Advantage plans with lower star-ratings get less money from the government for their services, which could affect the benefits they offer and shift more costs onto their enrollees.

Here’s more from Just Care:

Comments

2 responses to “2023 Medicare Advantage star ratings fall”

  1. David Ehrenfried Avatar
    David Ehrenfried

    It’s a pretty strong accusation to call the MA and PDP Stars ratings a “farce.” In reading the article, it’s pretty clear the author does not have a firm grasp on the Stars ratings measures and processes, how the measures change each year, and what they really say about MA and PDP plan performance. There are indeed many complexities associated with the measures and data collection, but the scores definitely provide Medicare beneficiaries with a credible overall score for assessing the relative quality of local MA and PDP plans. Certainly, it’s helpful to seek out anecdotal or other information from friends and others. The Stars ratings, however, are based on an objective methodology which makes them worth reviewing. (For example, one’s friends might say they’ve never had an issue with a 2.5 Star MA plan, but one should be cautious committing to such a plan for a year based on few friend’s experiences. If you get really sick, you’ll likely get the opportunity to find out why the plan had such low ratings.) A plan’s Stars ratings, of course, are not guarantees that the specific care or services an enrolled beneficiary receives from the plan’s participating providers or claims and service administrator will always reflect the rating. The ratings do speak to the many programs and processes the MA carriers have in place for tracking, ensuring, and improving quality and member satisfaction. That’s because the plans with higher ratings are likely to better in this regard in terms of experience and resources to devoted to quality management and improvement.

    1. Diane Archer Avatar
      Diane Archer

      Thanks for your comment, David. You are likely correct that the plans with one and two-star ratings should be avoided at all cost, but they are few and far between. The question is whether you can rely on a plan with a four or five-star rating to give you access to the care you need from quality providers in a timely manner. The star-ratings do not speak to access to quality providers or to inappropriate denial rates and delays with certain Medicare Advantage plans. The point of this post is to make clear that there are no quality guarantees at a Medicare Advantage plan with a five-star rating.

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