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Just 1 in 3 Medicare Advantage members familiar with CMS’ Star Ratings for plans

Insurance Forums Staff

Thirty-two percent of Medicare Advantage plan members with chronic conditions responded they were familiar with the Star ratings system used by CMS.

This is up from 22% awareness in 2018. Of those familiar, 49% used the grading system to help them choose a plan for 2019 enrollment compared to 51% percent last year. Most of the remaining percent who were unfamiliar with Star Ratings said they would use them once they were informed, with 74% of respondents in 2019 plans saying they would use Star Ratings to help choose a plan in the future, versus 75% in 2018. The results are from HealthMine surveys of 781 Medicare Advantage plan members fielded in June 2018, and 800 surveyed in 2019.

Despite most Medicare Advantage plan members not familiar with Stars, most are choosing plans with high ratings. According to an analysis in 2018, 74% of enrollees were in the plans with four or more Stars. Yet, the HealthMine data revealed that just 15% of the total respondent base of 800 used Star Ratings in picking a 2019 plan.

“Awareness of Star Ratings is slightly on the rise, but still low at less than one in three people. Yet, most Medicare Advantage enrollees are ending up in the highest rated plans,” said Jean Arrington, chief innovation officer at HealthMine. “We only expect that to grow and push to ubiquity where almost all members are in four-plus Star rated plans.

For plans, Arrington said 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,” she said. “We are seeing that our health plan clients that create deep connections with members are realizing results with high Star Ratings.”

About HealthMine
: HealthMine is the only Health Action as a Service company (HAaaS) originally built inside a Value-Based Insurance Design (VBID) health plan. HealthMine’s services help health plans target and empower individuals to take actions that improve clinical outcomes while decreasing total cost of care and increasing plan revenue. HealthMine is online at www.healthmine.com.



7 thoughts on “Just 1 in 3 Medicare Advantage members familiar with CMS’ Star Ratings for plans”

  1. When I did educational seminars for the local hospital I positioned the star ratings as one factor to look at when choosing a plan but it should be one of the lesser important factors. People really appreciate this info because some of them were making it the #1 factor when choosing a plan and chose the wrong plans because of it.

    The #1 factor (my opinion of course) is the drug formulary. If you are taking expensive medications compare the cost of your meds with all of the plans you are considering. There can be thousands of dollars difference between the plans. A four star rating does not trump a two or three star if the formulary doesn’t work for you.

    The #2 factor- Doctor network. Are the doctors you want to see in network? Don’t fall for the PPO means you can see any doctor BS. Not in the real world. And the co-pays would be much higher even if you could.

    #3 cost- how much are the premiums, co-pays and deductibles? How do they compare?

    Only after comparing those important and personal you factors of the Advantage plans should the star ratings be considered. It’s one factor. But not as important to your happiness with any particular plan as the other things.

  2. I think people are concerned when its very low rating or may be impressed if 5 star, Mostly everything in between is a nonfactor even the low and high rating are not always a factor

    They care more if doc takes it If mary down the block said they are terrible , drug copays, dental and sometimes gym

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