The main cause of these better marks is improved plan performance, not CMS changes to cut-points, measures or methodology. “While the report notes that changes to certain individual measures did influence the ratings of some plans, overall the scoring changes largely canceled each other out.”
Other findings from the report, as summarized by FierceHealthPayer, include:
- “Although health maintenance organization plans outperformed the market in previous years, preferred provider organization plans ranked highest this year.
- “Plans built around integrated delivery networks (in particular, Kaiser Permanente) received a higher weighted average rating than plans offered by commercial carriers or Blues carriers. But commercial and Blues carriers continue to close the gap, the report notes.
- “Medicare Advantage plans with more members tended to do better, as the 2016 enrollment-weighted average star ratings are lower for carriers with fewer than 20,000 M.A. members than for carriers with M.A. enrollment between 20,000 and 100,000 or plans with more than 100,000 members.”