Beneficiary Engagement with Medicare Star Ratings Lagging

May 22, 2019 - More Medicare Advantage beneficiaries know about the Medicare Star Ratings than ever before, but the door is still wide open for CMS and health plans to educate consumers about making a plan purchasing decision, according to data from HealthMine.

The survey, which included responses from 800 Medicare Advantage beneficiaries, revealed that 32 percent of consumers knew about the CMS Star Ratings when purchasing their MA plans this most recent open enrollment season. This is up from 22 percent of patients who could say the same last year.

CMS hosts the Medicare Advantage Star Ratings to provide beneficiaries with a simple resource to understand health plan quality. These Star Ratings include information about beneficiary satisfaction, healthcare quality, and health plan network adequacy.

With such limited numbers of beneficiaries knowing about and using the Star Ratings, concerns arise about them making informed health plan purchasing decisions.

Half of those who knew about the Star Ratings used them to make their health plan purchasing decisions, suggesting that the grades are useful for consumers looking to buy into a high-quality health plan.

But when looking at all respondents, only a total of 15 percent of consumers used the Star Ratings to select their health plan. This gap suggests an opening for health plans, CMS, and other stakeholders to drive beneficiary education and inform them of the Star Ratings, as well as other tools that could assist them and their family caregivers in selecting a quality health plan.

A total of 74 percent of respondents said they would likely use the Star Ratings if they could have access to that educational information.

Despite these dismal findings, healthcare consumers are ultimately selecting the top-rated health payers, the survey authors continued. Seventy-four percent of market enrollees selected a health plan with four or more stars.

Those findings could suggest prudence on the part of healthcare consumers, in addition to a prevalence of highly-rated health plans currently on the market. When releasing their most current set of Star Ratings, CMS predicted that 74 percent of Medicare beneficiaries would have access to a plan rated four stars or higher.

A total of 21 health plans earned a five-star rating, CMS reported, while only four health plans earned 2.5 stars or lower.

“Medicare Advantage enrollees will continue to have access to high quality plans while plan choices are increasing and premiums are declining,” said CMS Administrator Seema Verma following the Star Ratings release.

“Along with the steps the Trump Administration has taken to maximize competition and lower out-of-pocket prices, we are committed to empowering Medicare beneficiaries to make informed choices in choosing high-quality plans that best fit their health needs.”

As more health plans continue to pursue high Medicare Advantage Star Ratings, experts predict that the overall quality of health coverage to improve.

"Awareness of Star Ratings is slightly on the rise, but still low at less than one in three people,” said Jean Arrington, chief innovation officer at HealthMine. “Yet, most Medicare Advantage enrollees are ending up in the highest rated plans. We only expect that to grow and push to ubiquity where almost all members are in four-plus Star rated plans. For plans, it means increased pressure to excel in performing in a value-based insurance design world. The engine driving plan performance is clearly each member taking the right health actions. We are seeing that our health plan clients that create deep connections with members are realizing results with high Star Ratings."

These results do indicate an improvement from last year. In 2017, only 22 percent of beneficiaries were aware of the Medicare Advantage Star Ratings, HealthMine reported. Fifty-one percent used the grades to make a health plan purchasing decision.