On October 9, CMS released its 2020 Star Ratings for Medicare Advantage (MA-PD) and Medicare Part D plans (PDPs) on Medicare Plan Finder. Based on September 2019 enrollment, 81% of MA-PD enrollees are in plans with at least 4 stars for 2020—an increase from 73% in 2019. The average enrollment-weighted star rating for MA-PD plans is expected to increase from 4.06 in 2019 to 4.16 in 2020. The average overall star rating for PDP contracts is expected to increase from 3.34 in 2019 to 3.5 in 2020.

Medicare Advantage plans increased performance for several of the individual measures that make up the star ratings for 2020. In particular, the following 3 Medicare Advantage measures had star rating increases of 0.5 stars or more: Improving or Maintaining Mental Health, Rheumatoid Arthritis Management, and Complaints About the Health Plan.

Most PDP enrollees are in plans with fewer than 4 stars in 2020. However, a higher percentage of enrollees are in plans with at least 4 stars in 2020 as compared to 2019. Some of the shifts in the PDP landscape are likely a result of updates to measures or changes to rating methods.

Insights from this year’s star ratings report include:

1. More contracts achieve 5-star status. For 2020, 20 MA-PD contracts have 5-star ratings. By contrast, 14 MA-PD contracts had 5-star ratings in 2019. 3 MA-PD contracts lost their five-star status in 2020 from 2019, while 11 maintained this star rating and 9 gained a five-star rating.
2. Very few PDP contracts achieved 5-star status. In 2020, only 2 PDP contracts have 5-stars.
3. Enrollment in MA-PD contracts with 4+ stars in 2020 is higher. In 2020, the percentage of contracts earning 4+ stars is projected to increase (from 45% to 52%). Approximately 81% of MA-PD enrollees are currently in contracts that will have 4 or more stars in 2020, an increase from 73% in 2019.
4. Medicare Advantage plan performance across measures generally improved. 3 measures had increases of 0.5 stars or more: Improving or Maintaining Mental Health, Rheumatoid Arthritis Management, Complaints About the Health Plan. For MA-PD plans, 8 measures increased, 3 decreased, and 3 had no change.
5. More enrollees are in in PDPs with 4+ stars. In 2020, 16 PDP contracts have at least 4 stars. Approximately 28% of individuals are enrolled in 4+ star plans, a notable increase from 3% in 2019.

Figure 1. Enrollment Distribution Across MA-PD Contracts by Star Ratings

Figure 2. Enrollment Distribution Across PDP Contracts by Star Ratings

Figure 3. Enrollment Distribution Across PDP and MA-PD Contracts by Star Ratings

Learn More at Our Upcoming Webinar

For additional analysis and details on CMS’ 2020 Star Ratings release and a look at what’s to come for 2021 and beyond, we invite you to register for our upcoming webinar—2020 Star Ratings: Quality Excellence Accelerating Consumer-Centric Care. Gain the actionable insights and strategies you need to support future operational and performance improvement initiatives. Register for this free webinar today.

To learn more about how Avalere can help you, connect with us.

Find out the top 2020 healthcare trends to watch.