More MA-PD, PDP Members Will Be in 4-Star Plans in 2022

by Leslie Small

CMS, in its recent release of 2022 star ratings for private Medicare plans, reported that the percentage of members in plans rated 4 stars and above rose for both Medicare Advantage Prescription Drug (MA-PD) plans and stand-alone Prescription Drug Plans (PDPs).

COVID breaks boosted ratings:

• An eye-popping 90% of current MA-PD enrollees are in plans that will be rated 4 stars or higher in 2022, up from 77% of MA-PD enrollees in 2021.
• Last year, CMS said that weighted by enrollment, about 17% of PDP enrollees were in contracts that would be awarded 4 or more stars in 2021. And in this year's fact sheet, the agency said that about 42% of current PDP enrollees are in contracts that received a rating of 4 or more stars for 2022.
• Melissa Newton Smith, executive vice president of consulting and professional services at HealthMine, Inc, says that "stand-alone PDP plans were artificially boosted by CMS' Star Ratings COVID relief provisions, with plans reverting to the measure-level 2021 rating on average more than 30% of the time."
• The average star rating for MA-PD contracts in 2021 was 4.06, and that figure rose to 4.37 in 2022. For PDPs, the average rating rose from 3.58 in 2021 to 3.70 in 2022. Typically, star ratings for stand-alone PDPs tend to be lower than for MA-PDs and MA-only plans.

Payers withdraw some standalone PDPs:

• Before it released the star ratings, CMS unveiled the 2022 MA and Part D Landscape files, which detail the numerous plan offerings available next year and their premiums.
• Tom Kornfield, a senior consultant at Avalere Health, says it's notable that even though the number of MA plans available next year is rising in 2022, the number of stand-alone PDPs shrunk slightly in 2022 compared to 2021.
• "I think that's really due to two organizations that have reduced their offerings, Cigna and Centene," Kornfield says. Centene, in particular, may have scaled back some of its legacy WellCare plans after closing its acquisition of the smaller insurer, he suggests.
• Despite the overall drop in stand-alone PDP plan availability, most states will see an increase in PDP options. There will also be a drop in average stand-alone Part D premiums, with 56 plans featuring monthly premiums under $10.

From RADAR on Drug Benefits