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CMS Issues Star Ratings for the 2014 Plan Year

Written by Theresa Carnegie and Roy Albert

On October 11, 2013, CMS posted the 2014 Medicare Health Plan Quality and Performance Ratings, which are commonly referred to as “Star Ratings.”  CMS released the 2014 Star Ratings several days later than originally scheduled, worrying some Plan Sponsors and analysts.  Although the new ratings are available on the Medicare Plan Finder, the website continues to display the message that some information may not be up to date as a result of the government shutdown.

As we have described in the past, Star Ratings serve as both an educational tool for Medicare beneficiaries and a metric that has considerable impact on Medicare Advantage and Prescription Drug Plan Sponsor reimbursement.  Today marks the first day of “open enrollment,” which continues through December 7, 2013, during when beneficiaries are eligible to enroll in Medicare Advantage and Prescription Drug Plans for the 2014 contract year.

Medicare Advantage plans, on average, received higher Star Ratings in 2014 when compared to 2013.  CMS reports that while the number of 5 star plans remains unchanged at 9 percent, 43 percent of plans will be rated four stars in 2014 when compared to 28 percent in 2013.  This considerable change indicates that Plan Sponsors have taken great strides to understand the importance of the Star Ratings system and have implemented changes to improve their scores.

The newly issued Star Ratings are available on the Medicare Plan Finder website.  CMS’s draft technical notes document sets forth the various measures reviewed, the methodology used to calculate a plan’s score, and the differences between how the newly released ratings differ from last year’s ratings.

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Roy Albert