The Centers for Medicare & Medicaid Services (CMS) late Friday announced the 2024 MA and Part D Star Ratings and released a fact sheet:
- Approximately 42 percent of MA-PDs (229 contracts) that will be offered in 2024 earned four stars or higher for their 2024 overall rating.
- Weighted by enrollment, approximately 74 percent of MA-PD enrollees are currently in contracts that will have four or more stars in 2024.
- Thirty-one MA-PD plans earned the highest rating of five stars for 2024, compared to 57 in 2023. Eleven of the contracts that received five stars for 2024 did not receive the designation in 2023.
CMS said that in general, higher overall Star ratings are associated with contracts that have more experience in the MA programs. MA-PDs with 10 or more years in the program are more likely to have four or more stars compared to contracts with less than five years in the program.
The Star ratings are meant to help seniors with Medicare compare health and prescription drug plans during Medicare open enrollment, which kicked off Sunday. Plans that earn at least four stars receive five percent quality bonuses, which they are to use to offer additional benefits to enrollees, reduce cost sharing, or provide innovations in care.
CMS changed the methodology for the 2024 Star ratings. MA-PD plans are rated on 40 quality and performance measures. MA-only contracts are rated on up to 30 measures, and PDP contracts are rated on up to 12 measures.
- For 2024, new measures added to Star ratings include an updated Plan All-Cause Readmissions (Part C), the Transitions of Care (Part C), and Follow-Up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (Part C) measures, each with a weight of one.
- The Diabetes Care-Kidney Disease Monitoring (Part C) measure was retired.
- The Part C Controlling Blood Pressure measure was increased from one to three.
- Data integrity issues are now included in the description of missing data in the extreme and uncontrollable circumstance (disaster) policy. For disaster-affected contracts with a data integrity issue, the final measure rating is based on the current year.
The other factor influencing the 2024 Stars is the introduction of Tukey outlier deletion, a statistical method for removing outliers when calculating Star measure cut points for all non-Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures to improve predictability and stability in Star ratings. The deletion removes outlier contract scores prior to applying mean resampling within the hierarchical clustering algorithm to determine measure-level cut points.
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The Tukey method is expected to improve the stability of cut points and prevent cut points from being influenced by outliers beginning with the 2024 Star ratings, explained Ana Handshuh, CHC, principal, CAT5 Strategies, and Melissa Smith, executive vice president, consulting & professional services, Healthmine, in an article last year for RISE. Through the use of the Tukey method, CMS intends to remove extreme outliers from measure scores prior to clustering to prevent these outliers from impacting cut points for all contracts. In doing so, CMS expects that it would be harder for plans to earn (or keep) their Star rating.
To better understand the impact of 2024 Star ratings, join RISE and Cotiviti for a webinar, Star Rating Reflections, at 1:30 p.m. EST, Thursday, Oct 26. In addition, RISE will host a webinar, Innovation: The Secret to Higher Star Ratings, 1:30 p.m. EST, Thursday, Nov. 16 (first 50 registrants get in free). For a deeper dive into Star ratings, join RISE for our 14th annual Star Ratings Master Class conference, which will take place December 11-13 in San Diego.