Medicare Advantage star ratings show steep declines for 2023 as pandemic flexibilities go away

Approximately 51% of Medicare Advantage (MA) plans offering drug coverage will have a star rating of four or more in 2023, a sharp drop compared to 68% of plans with such a rating or higher for 2022. 

The Centers for Medicare & Medicaid Services (CMS) released the 2023 star ratings for MA and Part D plans to help seniors compare options for Medicare 2023 open enrollment, which starts Oct. 15. The new findings show that record increases in plans with high star ratings are on the decline as several regulatory flexibilities are going away in 2023. 

CMS announced that 51% of MA plans with drug coverage will have a four-star rating or higher in 2023, which is a drop compared with 68% for 2022

It also found that 72% of people currently in an MA drug coverage plan are enrolled in one with four stars or higher, a drop compared to 90% for 2022.

“Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance,” CMS said in a release. “Star Ratings are released annually and reflect the experiences of people enrolled in Medicare Advantage and Part D prescription drug plans.”

CMS also reported that 31% of standalone Part D plans active in 2023 received a star rating of four or more, and about 9% of part D plan enrollees are currently in such a plan.

The agency added there are 62 contracts that have five stars, with 57 of them as MA prescription drug offerings. Only one of the plans will be flagged as low performing. However, in 2022 there were no plans that got such a warning, according to a fact sheet on the plans. 

There are several reasons that could explain the decline from 2022 to 2023 in star ratings. For one, next year CMS will remove a disaster provision put in place to help plans in response to the COVID-19 pandemic. 

The provision enabled plans to pick the “better of” on 28 quality and performance measures, meaning they could take the best score. CMS is also putting more weight on the Consumer Assessment of Healthcare Providers and Systems survey, adding more pressure on plans to keep a high rating.

The star ratings are pivotal to help differentiate plans amid a highly competitive marketplace. They also determine the amount of quality bonuses plans can receive.

CMS has already announced that premiums for MA plans will drop by nearly 8% for 2023