Increased Weights, Cut Points Likely Led to Drop in 2021 Stars

Although more than three-quarters of Medicare Advantage beneficiaries remain in highly rated plans, the percentage of MA Prescription Drug (MA-PD) plan enrollees estimated to be in contracts receiving 4 or more stars in 2021 fell by approximately 4 percentage points from 2020. That overall takeaway from the Oct. 8 release of the 2021 star quality ratings was somewhat surprising, given that there were no new measures for 2021 and CMS used some of the same data to ease reporting burden during the pandemic, but a deeper look at the results reveals several factors at play, industry experts tell AIS Health.

According to the CMS Fact Sheet released alongside the stars data, approximately 49% of MA-PD plans (194 contracts) that will be offered in 2021 earned overall star ratings of 4 or higher, compared with 52% of MA-PDs (210 contracts) offered in 2020. Weighted by enrollment, roughly 77% of MA-PD members are currently in contracts that will have 4 or more stars in 2021, down from about 81% in 2020, estimated CMS. And the average MA-PD star rating weighted by enrollment fell from 4.16 in 2020 to 4.06 for 2021.

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