Only 2% of Medicare beneficiaries who enrolled in a stand-alone Prescription Drug Plan (PDP) in 2024 will be in contracts with 4 or more stars, compared to 42% in the 2022 plan year and 9% in 2023, according to CMS’s recently released estimates. The average Star Rating for PDPs dropped to 3.11 in 2024 from 3.70 in 2022, with two contracts receiving 1.5 stars.
The distribution change is largely fueled by methodology changes in how many of the Star Ratings are calculated. Known as Tukey outlier deletion, the changes center on removing outlier contract scores when determining the cut points for all non-Consumer Assessment of Healthcare Providers and Systems measures.
Based on current enrollment, CVS Health Corp.’s SilverScript Insurance Company, the largest PDP sponsor, will have all of its enrollees in a plan with 3 stars in 2024. Meanwhile, The Cigna Group saw its largest contract’s rating drop from 4.0 stars to 2.5, and as a result, 63% of its current members will be in a 2.5-star contract in 2024. Among the top PDP players by membership, only Wellmark Blue Cross and Blue Shield of Iowa, which covers approximately 175,000 enrollees, scored a 4.
Scores for some 2024 Star Rating Part D measures changed significantly compared to data from the prior year at the national level. The score on Foreign Language Interpreter and Teletype (TTY) Availability dropped from 4.1 in 2023 plan year to 3.0 in 2024. The Drug Plan Quality Improvement measure saw the largest increase, from 2.2 last year to 2.9 in 2024.
This infographic was reprinted from AIS Health’s biweekly publication Radar on Drug Benefits.