Medicare Advantage

CMS Releases Star Ratings for 2023 Medicare Advantage and Part D Plans

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The Centers for Medicare & Medicaid Services (CMS) recently unveiled the 2023 Star Ratings for Medicare Advantage and Part D prescription drug plans. CMS assesses private Medicare health and drug plans on a range of categories. The overall goal is to help Medicare members identify plans that perform well and to enroll in top-tier coverage.

The more stars a plan earns, the higher it performed across the range of metrics CMS uses to assign these ratings. Star ratings go from 1 star (worst performing) to 5 stars (best performing) and are updated each year in time for open enrollment.

Medicare Open Enrollment runs from October 15th through December 7th.

The Stats on 4+ Star Programs

Of the 500+ contracts that CMS rated for 2023, 57 contracts were rated 5 stars. Overall, 51% of the contracts rated for next year received 4 stars or better.

Additionally, 72% of current enrollees in private plans already belong to plans rated 4 stars or better.

Of the many Medicare Part D PDPs on the market for 2023, only two were ranked 5 stars and both were non-profits. About 31% of all Part D plans had a score of 4 stars or higher. And about 9% of current enrollees in Part D plans already belong to plans that have a star rating of 4 or higher.

Open Enrollment

Medicare Open Enrollment (also called Annual Enrollment) is the one time each year when current Medicare enrollees can evaluate their coverage and make changes for the coming year. Costs are trending downward for 2023, with wider access to $0 Medicare Advantage coverage and lower Part D premiums as well. CMS star ratings help enrollees make better sense of what’s available.

Trends for 2023

CMS released the full data on 2023 premium and coverage for Medicare Advantage and Part D plans back on September 29th. Comparing rates from each year indicates that 2023 will have lower premiums for both plans when compared to the statistics for 2022.

Furthermore, the effects of the Inflation Reduction Act means that any recipient of Medicare prescription drug coverage is going to have better, cheaper benefits, like a $35 cost-sharing limit on monthly supplies for covered insulin products. Medicare members can now also receive adult vaccines that have been recommended by the Advisory Committee on Immunization Practices without paying out of pocket.

Getting into the Weeds

The data sheet released by CMS includes a breakdown of services and how much they improved or worsened in their nationally averaged score from 2021 to 2023. Some of the more interesting shifts within this data are highlighted below, with the specific rating for 2023 given in parentheses at the end of each point.

Medicare Advantage (Part C)

  • A 2.04 point decrease in improving bladder control (43.42)
  • A 1.68 point decrease in quickly getting appointments and care (77.28)
  • A 1.8 point decrease in getting necessary care (81.21)
  • A 2.02 point decrease in reducing falling risks (53.28)
  • A 2.22 point decrease in providing foreign language interpretation and TTY services (89.87)
  • A 2.47 point decrease in plan members choosing to leave their plan (17.15)
  • A 2.57 point increase in controlling the blood sugar of diabetic patients (78.92)
  • A 1.79 point increase in eye exams for diabetic patients (72.30)
  • A 5.36 point increase in managing osteoporosis in women who had experienced one or more fractures (45.00)

Part D MA-PD

  • A 1.98 point increase in statin use among diabetic patients (84.84)
  • A 2.86 point decrease in plan members choosing to leave their plan (17.54)

Part D PDP

  • A 1.98 point increase in statin use among diabetic patients (82.25)
  • A 1.01 point decrease in getting needed prescription drugs (89.55)
  • A 1.62 point decrease in rating the plan (82.53)

Beyond the stats, 2023 has also seen 11 different contracts getting a high quality mark that did not get this mark in 2022. Also, it seems that nonprofit Medicare Advantage with prescription drug coverage plans tend to be rated more favorably than for-profit plans of the same type (72% vs. 43%).