What are Medicare Advantage STAR Ratings?

Medicare measures how well Medicare Advantage and Medicare Part D plans perform by giving them a STAR rating. Medicare STAR ratings are given on a five point scale, with five stars being the highest possible score. STAR ratings are made up of several sub-categories. Medicare shoppers can view both a plan’s overall score and the plan’s score in the subcategories. The Medicare Advantage STAR subcategories measure whether members are taking preventative health measures, how well member chronic conditions are being managed, how responsive the plan is to member needs, and the quality of customer service provided to members. For Part D plans, STAR ratings are primarily focused on customer experience and drug plan pricing.

Along with giving consumers additional information when shopping for Medicare Advantage plans, STAR ratings impact the business performance of health insurance companies in a multitude of other ways: (1) Five star plans are eligible for the special enrollment period – beneficiaries can join these plans at any time (2) Online enrollment gets disabled for consistently poor performing plans (3) High performing STAR rating plans result in financial bonuses from CMS.

 

 

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