Surveys show only 32 percent of patients understand the CMS Star Ratings, and only 15 percent use them to make health plan decisions.
Patient education about the Medicare Advantage Star Ratings still leaves much to be desired, with just about one in three patients reporting any sort of awareness of the ranking system, according to new data from HealthMine.
CMS hosts the Medicare Advantage Star Ratings as a patient-facing tool to help beneficiaries and their family members make informed decisions about where to purchase supplemental health insurance coverage. The use of five-star ratings makes it quick and easy for beneficiaries to understand health plan quality and make an informed decision.
But only about 32 percent of beneficiaries know about the Star Ratings, a survey of about 800 MA beneficiaries showed. Of those who were familiar with the ratings, only 49 percent used them to make a health plan enrollment decision.
Despite these dismal results, they do represent some positive growth from years before. A similar survey conducted by HealthMine in 2018 revealed that only 22 percent of beneficiaries were familiar with the star ratings. Fifty-one percent used the grades to make an enrollment decision.
Ironically, patients are still selecting what HealthMine said are high-quality plans, regardless of whether or not they consulted with the Star Ratings. Seventy-four percent of beneficiaries selected a health plan ranked four stars or higher in 2018. In 2017, 68 percent of beneficiaries selected a plan rated at least four stars.
Patients expressed interest in learning more about the Star Ratings and a willingness to use them in the future. Seventy-four percent said they would use the Star Ratings if they knew more about how they work, while 75 percent said the same in last year’s survey.
These results indicate that CMS must do more to drive beneficiary education around health plan quality, said Jean Arrington, chief innovation officer at HealthMine.
“Awareness of Star Ratings is slightly on the rise, but still low at less than one in three people,” Arrington said in a statement.
Similar proportions of patients said they were willing to learn more about the CMS Star Ratings between 2018 and 2019. These patients also noted plans to adopt the rankings into their healthcare decision-making process, so long as they could learn more about them.
And although this year’s survey did mark some improvements, they are modest at best.
These results highlight room for more patient and consumer education about healthcare decision-making and CMS offerings. The agency can do more to ensure Medicare members understand clinical quality and the options set before them.
Lapses in beneficiary education aside, these results are a boon for the health payer industry, as patients continue to make good decisions leading them to quality health plans.
“Most Medicare Advantage enrollees are ending up in the highest rated plans,” Arrington added. “We only expect that to grow and push to ubiquity where almost all members are in four-plus Star rated plans. For plans, it means increased pressure to excel in performing in a value-based insurance design world. The engine driving plan performance is clearly each member taking the right health actions. We are seeing that our health plan clients that create deep connections with members are realizing results with high Star Ratings.”
Although few patients are aware of the Star Ratings, these care quality measures receive considerable industry recognition or, in some cases, scrutiny. Some experts say that clinical quality involves too many aspects to distill into a five-star score, a common critique of the system CMS otherwise intended to be simple for patients.
Others have suggested risk-adjusting quality scores to account for plans covering large populations of patients experiencing the social determinants of health. Health plans serving patients living in rural areas, who are low-income, or who experience homelessness or hunger may benefit from score adjustments that account for those inequities.
Date: May 24, 2019