Oct 7, 2022 - Health

Medicare Advantage star ratings fall

Illustration of a hundred dollar bill puzzle with pieces missing out of the center in the shape of a red cross

Illustration: Sarah Grillo/Axios

Medicare administrators released Medicare Advantage plan star ratings Thursday, revealing the average rating for the private plans has fallen compared to last year.

Why it matters: The Medicare enrollment period kicks off Oct. 15 and roughly half of the 59 million eligible Medicare beneficiaries are expected to enroll in private Medicare plans.

  • The ratings, which are based on 38 performance and quality measures, are meant to guide seniors to the highest-performing plans — but can also have a big financial impact on insurers.

State of play: According to CMS, the average rating across all plans is 4.15 out of a possible 5 stars for next year. That's down from 4.37 in 2022 and 4.16 in 2020.

Between the lines: Ratings were expected to fall this year as CMS dropped relaxed pandemic-era criteria, Modern Healthcare reported.

  • That includes scores that are more heavily weighted to consumer satisfaction, which could be problematic for many plans.
  • The stars can also affect whether plans can be marketed throughout the year, rather than only during open enrollment, per Modern.
  • Analysts have predicted the ratings changes could cause an $800 million impact on plans, per an analysis by McKinsey and Co.
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