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Star ratings for Medicare Advantage, Part D see sharp drop for 2023, CMS shows

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The average star rating for Medicare Advantage plans with drug coverage in 2023 will be 4.15 stars out of five, a drop from the record high of 4.37 stars in 2022, the Centers for Medicare & Medicaid reported Thursday. The average for 2023 is similar to 2020 and 2021, when it was at 4.16 stars and 4.06 stars, respectively.

There are 260 MA plans with Part D coverage that received four stars or more for 2023, a share of about 51%. This is a steep drop from 2022, when there were 322 plans with four stars or more, accounting for about 68% of plans.

For 2023, 57 plans (about 11%) received a five-star rating, compared to 74 (almost 16%) in 2022. Some of the highest performing plans include from Humana, UnitedHealth Group and Kaiser Foundation Health Plan, which all received five stars last year as well.

About 72% of all enrollees in MA plans with drug coverage are currently in ones that will have four or more stars in 2023, CMS reported. 

The star ratings system is in place to help consumers choose plans ahead of open enrollment, which begins October 15. MA plans with drug coverage are rated on 38 quality and performance measures, such as adult body mass index, breast cancer screening and diabetes care.

Factors that likely contributed to the decrease in star ratings include ongoing challenges with Covid-19 and changes to CMS’ methodology and measurement, according to a statement by Matt Eyles, CEO of America’s Health Insurance Plans (AHIP). One of the changes was a removal of a disaster provision CMS had in place for 2022, which protected plans during Covid-19.

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,” Eyles said in the statement.

MA plans have been gaining popularity in recent years, accounting for 48% of all Medicare enrollees, according to a recent report by Kaiser Family Foundation. MA enrollment has more than doubled since 2007, when it was 19% of the Medicare population. As soon as next year, KFF predicts this number could surpass the 50% threshold.

Eyles also touted MA as a lower-cost option than traditional Medicare. MA plans spend about $1,965 less on out-of-pocket costs and premiums, according to a recent report by Better Medicare Alliance.

“Medicare Advantage is a prime example of the government and free market working together to deliver lower costs, more choices, and better outcomes for the American people,” Eyles said. “AHIP will continue to work with the Administration, Congress, and other stakeholders to ensure Medicare Advantage remains strong and vibrant for the millions of Americans who depend on it for good health.”

Photo: designer491, Getty Images

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