Featured Infographic   As Expected, Top MA-PD Payers See Star Ratings Declines   The average star rating for Medicare Advantage Prescription Drug (MA-PD) plans declined following the phaseout of pandemic-related flexibilities, according to CMS. While 72% of MA-PD beneficiaries are enrolled in a contract that is rated at least 4 stars for 2023, that’s down from an all-time high of 90% in 2022. These drops were anticipated however, as CMS in 2022’s ratings qualified all contracts under an “extreme and uncontrollable circumstances” policy to account for the COVID-19 public health emergency (PHE), which allowed payers to pick “best of” scores on many measures. Also, for 2023, the agency assigned a greater weight to member experience measures based largely on contracts’ Consumer Assessment of Healthcare Providers and Systems, after CMS suspended the collection of CAHPS survey data during the PHE.   Among the largest MA-PD payers, some ratings drops were more serious than others. UnitedHealthcare, which enrolls nearly one-third of the national MA market, has 80.2% of its MA-PD members enrolled in a contract rated at least 4 stars for 2023, compared to 94.8% in 2022. For No. 2 payer Humana Inc., that number was virtually unchanged, declining from 97.4% to 96.0%. This also held true for Highmark Health and Kaiser Permanente, which both enrolled 100% of their members in contracts rated at least 4 stars in 2022 and 2023. Centene Corp., which had already signaled its 2023 ratings would be disappointing, was the only payer in the top 10 to have any contracts score below a 2.5, though it has yet to qualify for a low-performance warning from CMS. CVS Health Corp.’s Aetna, Elevance Health (formerly known as Anthem, Inc.) and Cigna Corp. also had sizable ratings declines.

NOTES: Analysis does not include enrollment data from contracts that were too new to be rated or did not have enough data available to measure a star rating. About 73,000 of Humana Inc.’s MA-PD members were enrolled in a contract rated 2.5 stars. Guidewell Mutual Holding Corp.’s enrollment includes its January 2022 acquisition of Triple-S Management Corp. It is also the parent company of Florida Blue and Capital Health Plan, Inc. Kaiser Permanente’s enrollment figures represent the sum of its seven regional managed care organizations. SOURCES: CMS. DHP, AIS’s Directory of Health Plans, as of October 2022.   From Radar on Medicare Advantage Learn more about subscribing to AIS Health's publications.