Most MA Plans in Annual CMS Report See Star Ratings Increase

Ahead of Medicare open enrollment, which starts October 15, CMS released its annual report of which Medicare Advantage (MA) and Part D drug plans achieved 5-star ratings.

CMS said Friday that 87 Medicare Advantage (MA) plans reached 5-star status for 2022, including 60 plans that did not reach that level in 2021.

The annual report includes MA plans alone and MA plans with prescription drug coverage (MA-PD).

Of the 87 MA plans with 5 stars, 74 are MA-PD plans.

Weighted by enrollment, about 90% of beneficiaries in MA-PD plans are in contracts that will have 4 stars or more in 2022.

Eleven quality measures in MA plans saw increases, and 3 experienced increases of more than 2 points: Special Needs Plan Care Management; statin therapy for those with cardiovascular disease; and medication reconciliation post discharge.

However, most quality measures declined, including ones most often cited as being affected by the COVID-19 pandemic, such as breast cancer screenings and measures related to diabetes care, such as blood sugar control and eye exams.

No plans were identified as being a “consistently low performer,” CMS said.

“The Medicare Advantage and Part D Star Ratings are important tools in the toolbox for beneficiaries to use as they consider Medicare coverage options,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “CMS’s annual ratings deliver meaningful information about the quality of each plan to help people with Medicare make informed health care decisions.”

The report also compared plans by tax status. CMS said plans offered by nonprofit organizations more frequently earn higher ratings than for-profit companies. For MA-PDs, approximately 82% of the nonprofit contracts received 4 or more stars, compared with 62% of the for-profit MA-PDs. Similarly, for prescription drug plans alone, approximately 64% of nonprofit plans received 4 or more stars compared with 45% of the for-profit ones.

The COVID-19 pandemic affected how the report was quantified, as CMS delayed the implementation of measure cut point restrictions, removed 2 quality measures, and expanded the hold harmless provision.