The Centers for Medicare & Medicaid Services (CMS) have released the annual Star Ratings report for MA and Part D ahead of Medicare’s open enrollment period. These ratings enable consumers enrolled in Medicare Advantage (MA) and Prescription Drug Plans to compare the quality of health and drug services so they can make informed healthcare decisions. Plans are rated on a one-to-five scale, with five stars representing the highest level of performance.
2024 Medicare Advantage Star Ratings fell for the second year in a row, representing the 'final fallout' from COVID-19. Two years ago, there was significant inflation in MA star ratings due to the Centers for Medicare and Medicaid Services relaxing its measures. This year, ratings declined again due to various factors, including the addition and retirement of some measures and the deletion of the Tukey Outlier Deletion.
Continue reading to learn more about 2024 Medicare Advantage Star Ratings.
Changes to Star Rating scoring
Medicare Advantage Star Ratings are determined by 40 quality and performance measures. Plans are scored on their clinical quality outcomes and member satisfaction. Changes to the 2024 scoring methodology include :
- The Diabetes Care – Kidney Disease Monitoring (Part C) measure being retired
- The Transitions of Care (Part C) and Follow-Up After Emergency Department Visit for People with Multiple HighRisk Chronic Conditions (Part C) measures being added, each with a weight of 1
- The weight for the Part C Controlling Blood Pressure measure was increased from 1 to 3
- The introduction of the Tukey outlier deletion when calculating the cut points for all non-Consumer Assessments of Healthcare Providers and Systems (CAHPS) measures in order to improve predictability and stability in the Star Ratings.
The CMS updates measures and their weights every year. The update to the scoring methodology makes it harder to get five stars.
The decline in Star Rating scores
The average Medicare Advantage Star Rating declined for the 2024 contract year from 4.14 in 2023 to 4.04 in 2024 . Plans receiving a 5-star rating declined from 57 in 2023 to 31 in 2024. Around 42% of Medicare Advantage-prescription drug contracts (229 contracts) earned four stars or higher, down from 51 percent last year .
Addressing this decline in scores is important as almost three-quarters (74 percent) of beneficiaries are enrolled in plans that received four or more stars in 2024 .
Why Star Ratings matter
Star Ratings are important because they determine the quality bonus payments a plan is eligible for. Plans must earn a four-star rating or higher to receive a quality bonus payment. The difference between a 3-star and a 4-star plan is millions of dollars.
Bonus payments enable plans to make service enhancements, which also helps them get more members to enroll. Additionally, plans that earn a 5-star rating can hold open enrollment all year round. With more competition in the Medicare Advantage market than ever, finding ways to improve is key to standing out.
How LetsGetChecked can help boost Star Ratings
LetsGetChecked helps health plans close care gaps by meeting members where they are with accessible and convenient care. Our member-centric solutions drive engagement, boost compliance, and enable better outcomes to help meet HEDIS measures and improve Star Ratings.