Medicare Advantage, Part D plans with 4 or more stars soaring, CMS says

By | October 12, 2021

Dive Brief:

  • CMS released its 2022 rankings designed to help beneficiaries compare Medicare Advantage and Medicare Part D prescription drug plans ahead of Medicare open enrollment, which begins Friday and runs through Dec. 7.
  • The agency ranks plans on a scale of one to five stars that beneficiaries can see through Medicare.gov. About 68% of MA plans offering prescription drug coverage will have four or more stars in 2022, up from 49% in 2021, according to a CMS press release from Friday.
  • About 90% of people currently enrolled in MA plans offering prescription drug coverage are enrolled in a plan that will earn four stars in 2022.

Dive Insight:

CMS made adjustments to next year’s ratings due to the impact of the COVID-19 pandemic, though the uptick in plans scoring four stars or higher also reflects improvements made on several measures the agency takes into account, CMS said.

In light of the pandemic, CMS said it “wanted plans to have some degree of certainty related to Star Ratings program requirements,” and it wanted to make sure plans were focused on providing care for beneficiaries. The agency traditionally calculates star ratings based on measure data from the prior year, though it used 2020 data in calculating 2022’s scores to account for pandemic disruptions.

Despite an uptick in plans scoring four or more stars next year, the program has long faced controversy from critics who say the grades are arbitrary and sometimes burdensome.

The scores come as the MA program continues to grow at a record pace, as more Americans than ever are covered by the privately run plans and as insurers are attracted to the lucrative market.

UnitedHealthcare is the largest private insurer in the U.S. and has the most MA enrollees with plans in all 50 states. Others, like Cigna, are expanding offerings for the third year in a row and currently have plans in more than half of the states.

CMS ranks the performance of MA plans with prescription drug coverage on 38 quality and performance measures. It ranks MA-only contacts not including prescription drug coverage on up to 28 measures, and stand-alone PDP contracts on up to 12 measures.

A total of 87 contracts will earn five stars in 2022, 60 of which did not receive that highest performance rating in 2021, according to a fact sheet.

No plans scored with a low performance icon for consistently low quality ratings, compared with one plan that did in 2021.

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