Medicare Advantage star ratings increase as consumer options grow

Medicare Advantage star ratings increase as consumer options grow


More Medicare Advantage plans scored high quality ratings for their 2022 plans than the year before, according to data released by the Centers for Medicare and Medicaid Services on Friday.

Of the 322 Advantage plans with prescription drug coverage that received a rating, roughly 68% earned four stars or higher on a scale of one to five stars, with five being the highest. For 2021 plans, 49% scored four stars or more.

A greater percentage of seniors are also currently enrolled in plans that will have four stars or more next year, according to CMS. The agency said that, weighted by enrollment, 90% of Advantage members are in plans with four stars or higher, compared with just 77% for 2021. Those weighted enrollment figures are subject to change as CMS reviews the data.

Meanwhile, the average star rating for standalone prescription drug plans was 3.7, improved from 3.58 stars the year before. Forty-two percent of enrollees in prescription drug plans are in contracts with four or more stars, more than double the 17% of beneficiaries who enrolled in plans with the same rating the year prior.

The Medicare Advantage star ratings, born out of the Affordable Care Act, are meant to measure the quality of services that seniors receive. CMS says the ratings also reflect seniors’ experience with their plans and can be used to help them shop. Medicare open enrollment runs from Oct. 15 to Dec. 7. The agency did not immediately respond to an interview request about what could have contributed to the bump in health insurers performance.

“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 news release. “CMS’s annual ratings deliver meaningful information about the quality of each plan to help people with Medicare make informed healthcare decisions.”

The ratings are also critical for health insurers. Plans that score four stars or more receive a 5% increase to their benchmark, which is the maximum amount the federal government will pay, plus other advantages. Those extra dollars can be used to fund extra benefits for seniors, though it’s not a requirement. These quality bonus payments add about $6 billion to Medicare program expenditures each year, according to the Medicare Payment Advisory Commission.

Medicare Advantage is by far the most profitable product for health insurers. National carriers UnitedHealth Group, Humana, Cigna and more all announced geographic expansions of their Medicare Advantage products for 2022.


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