2020 Medicare Advantage Boom
July 24, 2019
How payers make money
November 19, 2019

2020 show more 4 star or higher plans

Medicare Advantage star ratings for 2020 show more 4 star or higher plans

There are 1,200 more MA plans than in 2018 and in 2020 a greater number rate 4 stars or more, CMS says.

The Medicare Advantage and Part D star ratings for 2020 show that more plans this year rated 4 stars or higher as opposed to last year.

Also, there are more plans being offered going into open enrollment starting October 15. There’s about 1,200 more Medicare Advantage plans operating in 2020 than in 2018, according to the Centers for Medicare and Medicaid Services, which released the ratings today.

Approximately 52 percent of contracts for Medicare Advantage plans offering Part D coverage earned 4 stars or higher, compared to about 45% in 2019.

Of 401 total contracts for 2020, 210 are at 4 stars or higher, compared to 172 in 2019 when there were 376 contracts.

Twenty contracts for MA and Part D earned 5 stars; 72 earned 4.5 stars; and 118 earned 4 stars. This compares to 14 that earned 5 stars in 2019; 64 that earned 4.5 stars; and 94 that earned 4 stars last year.

Weighted by enrollment, approximately 81% percent of MA-PD enrollees are currently in contracts that will have 4 or more stars in 2020, an increase from 69 percent in 2017, according to CMS.

The comparison between 2020 and 2019 shows 55 contracts rated 3 stars for 2020 as opposed to 66 in 2019.

The average star rating for 2020 is 4.16, compared to 4.06 in 2019 and 4.02 in 2017.

In 2020, approximately 28% of enrollees will be in stand-alone prescription drug plans with 4 stars or higher, an increase from approximately 3% in 2018. And the average star rating for a stand-alone prescription drug plan has improved from 3.34 in 2019 to 3.50 in 2020.


WHY THIS MATTERS

The star ratings are important to both insurers and beneficiaries.

The rating system rates Medicare health and drug plans on a rating of 1 to 5 stars, with 1 representing poor performance and 5 stars representing excellent performance.

Medicare Advantage has high satisfaction rates, premiums are lower this year and more insurers are offering plans.

More than 24 million people with Medicare, about a third of the Medicare population, are projected to enroll in Medicare Advantage for 2020. Medicare open enrollment begins on October 15, and ends on December 7.

Medicare beneficiaries can compare health coverage choices and the star ratings through the online Medicare Plan Finder tool available at Medicare.gov.


THE LARGER TREND

Each year, CMS publishes the Medicare Advantage and Part D star ratings that include measures on the experiences of beneficiaries.

Medicare Advantage with prescription drug coverage contracts are rated on up to 45 unique quality and performance measures; MA-only contracts (without prescription drug coverage) are rated on up to 33 measures; and stand-alone PDP contracts are rated on up to 14 measures.

Also each year, CMS conducts a comprehensive review of the measures that make up the star ratings by assessing the reliability of the data, clinical recommendations, and feedback received from stakeholders.

There are no new measures introduced for 2020, but earlier this year, CMS enhanced the star ratings methodology to better account for differences in a plan’s enrollee population.

CMS expanded the adjusted measure set included in the categorical adjustment index, which was first implemented in 2017, to address the within-contract disparity in performance associated with a contract’s percentages of beneficiaries with low income subsidy, dual eligibility, and disability. This expansion accounts for differences in performance, rather than differences in the populations, CMS said.


ON THE RECORD

“Thanks to the President’s leadership and commitment, the improvements that CMS has made to the Medicare Advantage and Part D programs means that seniors will have access to more high-quality plans,” CMS Administrator Seema Verma said. “Proposals for more government in our healthcare – such as Medicare-for-All – would eviscerate the progress we’ve made to strengthen the program by empowering patients to make informed choices in choosing high-quality plans that best fit their needs.”