The 2021 Medicare Advantage Star Ratings add to the positive narrative around the Medicare Advantage program as quality of care increases and accessibility continues to be strong.
CMS has released Medicare Advantage Star Ratings for 2021 and the results demonstrate a continuation of last year’s positive trends.
Medicare Advantage health plan quality steadily continued its upward trajectory into 2021.
Twenty-one Medicare Advantage-Part D plans received a five-star rating, with 28 contracts in total receiving this score when Part D plans and cost contracts are included. That total of 28 contracts is five more plans than last year.
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Kaiser Foundation and UnitedHealth Group emerged as leaders in Medicare Advantage-Part D plan quality this year. Kaiser Foundation had six health plans that received the high performing indicator. Four UnitedHealth Group plans attained five stars, three of which had never received a five-star rating in the past.
The other 11 five-star health plans came from University of Wisconsin Hospitals and Clinics Authority—which had two high-scoring plans—Tufts Health Plan, Kelsey-Seybold Medical Group, Humana, Health Partners, Capital District Physicians’ Health Plan, Cigna, Anthem, Martin’s Point Health Care, and HealthNow New York.
Length of time in the Medicare Advantage space and Medicare Advantage star ratings appear to be tightly correlated. Plans with ten years or more in the Medicare Advantage program were twice as likely to score four or more stars compared to plans that had been in the program for half as much time or less.
High-quality Medicare Advantage plans continue to be fairly accessible nationwide.
“Highly rated (4 stars or greater) MA-PDs continue to be available in the vast majority of regions across the country,” the fact sheet stated. “Between 2020 and 2021, there was a small downward shift in the enrollment-weighted mean rating.”
Thirteen health plans that received five stars this year did not receive five stars last year.
In comparison to the 2020 five-star ratings, several were absent from the 2021 list: Guidewell’s Florida Blue plan, Kaiser Foundation Health Plan’s H2172 contract, Health Partner’s Group Health Plan, Aetna’s H3597 contract, UnitedHealthcare Benefits of Texas plan, and Kaiser Foundation Health Plan of Washington.
The number of Medicare Advantage-Part D health plans that received a four-star rating or higher for 2021 rose four percentage points over 2017. Nearly half of the Medicare Advantage Part D plans fell in this category (49 percent) and on average the health plans received 4.06 stars.
As a result, more Medicare beneficiaries will have access to high-quality Medicare Advantage plans. Over three-quarters of Medicare Advantage beneficiaries (77 percent) will enroll in health plans that received four stars or higher. This represents an increase of eight percentage points over the past three years since 2017.
This news comes on the heels of a recent CMS announcement that premiums would continue to drop in 2021. Medicare Advantage premiums will be the lowest that they have been in 14 years and 34.2 percent lower than 2017 levels.
“The historically low premiums for Medicare Advantage plans this year would mean little if they didn’t come paired with high-quality care,” said CMS Administrator Seema Verma.
“With nearly half of Medicare Advantage plans with drug coverage rated at four stars or higher, and more than three-quarters of beneficiaries in Medicare Advantage plans with drug coverage enrolled in such four-star plans, seniors are coming out on top in 2021.”
The quality for prescription drug plans was lower than Medicare Advantage plans, with the average star rating being 3.58 stars, only a .08 percentage point increase over 2020.
However, nearly all beneficiaries that have stand-alone Medicare Part D prescription drug plans (98 percent) will be in plans with 3.5 stars or more in 2021. That is 28 percent more beneficiaries in higher quality plans than last year.
The rating system looked different this year, due to the global coronavirus pandemic. CMS suspended HEDIS quality measures so that health plans could focus their energies on the pandemic response and recovery efforts.
Thankfully, when the shutdown occurred, most health plans had already collected most of the necessary data for 2019 quality measurement, Frank Micchiche, vice president of public policy and external relations at the National Committee for Quality Assurance (NCQA) said on the Healthcare Strategies podcast.
Micciche urged payers to consider a more drastic shift toward digital quality measures in light of the challenges they faced with manual data collection during the initial outbreak.
Source: Healthpayer Intelligence