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CMS Changes to the Medicare Advantage Star Rating Program Drive Significant Increases to Overall Star Ratings

This week, our In Focus section highlights a Wakely white paper titled, CMS Changes to the Medicare Advantage Star Rating Program Drive Significant Increases to Overall Star Ratings. Authored by Suzanna-Grace Sayre and Dani Cronick and published January 2022, this paper outlines the CMS modifications to the 2022 Star Ratings due to COVID-19, quantifies the estimated impact on 2023 MA spending, and discusses how these changes could influence the MA market in 2023.

In this paper, Wakely estimates that the impact of COVID-related EUC changes will increase 2023 Medicare Advantage (MA) spending nationwide by $3.15 billion, or $9.64 per member per month. This equates to an 0.8 percent increase in MA spending or MAO revenue overall. There are several components driving this unprecedented increase in Star Ratings but the largest is the favorable “better of” treatment all contracts received, where CMS used the better of 2022 or 2021 measure-level Star Ratings in virtually all of the Stars measures.

Although the changes increased Star Ratings overall, not all contracts benefited in the same way. This paper delves into some of the differences that various contracts see in their benefits. Dive in to find out more about how your plan may be affected in 2023!

Link to White Paper

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