Dive Brief:
- About 51% of Medicare Advantage plans offering prescription drug coverage in 2023 will have four or more stars, down from 68% of plans in 2022, CMS said in a press release.
- The decline reflects the unusual circumstance of nearly all plans qualifying for a regulatory adjustment for extreme and uncontrollable circumstances last year due to COVID-19, resulting in higher-than-normal star ratings distributions, the agency said.
- The annual rankings are designed to help beneficiaries compare the quality of Medicare Advantage and Medicare Part D prescription drug plans ahead of the open enrollment period, which runs from Oct. 15 through Dec. 7. Plans are ranked on a scale of one to five stars that beneficiaries can see through Medicare.gov.
Dive Insight:
Americans continue to flock to Medicare Advantage plans, attracted by affordable premiums, prescription drug coverage and networks that offer access to preferred doctors, hospitals and pharmacies.
More than 28 million people are enrolled in the privately run plans, or 45% of those eligible for Medicare, according to the insurance lobby AHIP. The number is more than double the enrollment in Medicare Advantage a decade ago. CMS has said enrollment could reach 31.8 million people in 2023.
Commercial insurers are ramping up their MA offerings in response. Cigna is the latest to announce plans to expand in the market, saying last week that it will boost its presence by 22% next year.
Weighted by enrollment, about 72% of participants in next year's MA plans with prescription drug coverage are currently in contracts that will have four or more stars, CMS said.
Matt Eyles, CEO of AHIP, said the continuing effects of COVID-19 and recent CMS methodological changes may have affected the 2023 star ratings, which primarily relate to the 2021 performance year. "Even so, the majority of Medicare Advantage enrollees are projected to be covered by high performing plans," Eyles said in a statement.
Non-profit organizations more frequently earned higher star ratings than for-profit organizations, CMS said. About 72% of the non-profit MA with Part D contracts received four or more stars, compared to 43% of the for-profit plans.
Plans with more experience in the MA program tended to have higher star ratings as well, CMS said. Those with 10 or more years in the program were more likely to have earned four or more stars, compared to plans with less than five years’ experience.
Medicare Advantage with Part D contracts are rated on up to 38 unique quality and performance measures.