3 revelations about this year's Medicare Advantage Star Ratings

Now that the 2016 Medicare Advantage (MA) Star Ratings are out, a new report drills deeper into the data to reveal trends among these increasingly popular plans.

The Centers for Medicare & Medicaid Services (CMS) ranks MA plans on a one-to-five-star scale each year, using the ratings to guide consumers to the best plans as well as determine its MA Quality Bonus Payments. This year's ratings signaled good news, as about 49 percent of MA plans with Part D prescription drug coverage (MA-PDs) earned four stars or higher for their 2016 rating, up from 40 percent of MA-PDs that did so for the 2015 ratings.

And the main cause of these better marks is improvements in plan performance, not CMS changes to cut-points, measures or methodology, the firm McKinsey & Company found in its analysis of the star ratings data. While the report notes that changes to certain individual measures did influence the ratings of some plans, overall the scoring changes largely canceled each other out.

Here's a rundown of other findings from the report:

  • Although health maintenance organization plans outperformed the market in previous years, preferred provider organization plans ranked highest this year.
  • As in past years, plans built around integrated delivery networks (in particular, Kaiser Permanente) received a higher weighted average rating than plans offered by commercial carriers or Blues carriers. But commercial and Blues carriers continue to close the gap, the report notes.
  • MA plans with more members tended to do better, as the 2016 enrollment-weighted average star ratings are lower for carriers with fewer than 20,000 MA members than for carriers with MA enrollment between 20,000 and 100,000 or plans with more than 100,000 members.

The MA program is expected to have 17.4 million enrollees by 2016, CMS has said, and a new report out this week found that MA members are more satisfied with their coverage than those enrolled in commercial plans. Yet the program has also been plagued by billing errors that may have led to millions in overpayments, previous government audits found.

To learn more:
- here's the report

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