By Lauren Flynn Kelly
According to CMS’s recent release of the 2020 star quality ratings, many Medicare Advantage beneficiaries continue to enroll in plans with 4 or more stars. There was also a notable shift of membership into highly rated Prescription Drug Plans, some of which made meaningful improvements on an individual basis even though PDP performance on average was stagnant.
More than half of Medicare Advantage Prescription Drug plans (210 contracts) that will be offered in 2020 earned overall star ratings of 4 or higher, compared with 46% of MA-PDs (172 contracts) offered in 2019, CMS reported on Oct. 11. Weighted by enrollment, approximately 81% of MA-PD enrollees are currently in contracts that will have 4 or more stars in 2020, up from about 75% in 2019.
Given that there were no substantial changes to the star measures in terms of weights or calculations this year, MA-PDs’ performance on average is “good evidence that the industry did a great job teaching to the test,” observes Melissa Smith, senior vice president of strategy and stars with Gorman Health Group.
Meanwhile, the percentage of enrollees in a PDP rated 4 or higher increased from a meager 3.5% in 2019 to approximately 28% for 2020 based on current enrollment, and the average star rating for PDPs rose from 3.34 in 2019 to 3.5 in 2020.
Individually, PDPs showed some significant performance increases, which Smith says may be attributable to pharmacy benefit managers “having really aligned services and offerings around their customers’ Part D star measure needs.”
On a measure level, MA-PDs showed improvements on 13 out of 33 Part C measures. And on the Part D measures, MA-PDs improved on eight measures, including on the three medication adherence measures. PDPs, meanwhile, performed better on average on 11 out of 14 measures.