Be The (Medicare) Star: Improve STAR Rating With Analytics Powered Therapy Adherence Strategy

Improving the quality of care and services to patients and enrollees is one of the key imperatives of the Affordable Care Act (ACA). Several initiatives and measures have been put in place to make this imperative an operational reality across the entire healthcare landscape. For several years, CMS has posted quality ratings of Medicare Advantage plans (STAR Ratings) to help Medicare beneficiaries.

Many have doubted (and still do!) the sensitivity and ability of the beneficiaries to measure the value they perceive in a plan and hence the impact STAR rating can bring about. In a recent study conducted by HealthPocket, Inc., CMS star ratings for Medicare Advantage (MA) plans have been found to be directly correlated with MA plans’ voluntary attrition rates among members. The study found the average MA attrition rate for two-star plans:

• The lowest level in the current ratings is 22%, compared with just 2% for the highest-rated (i.e., five-star) plans.
• The attrition rate rises steadily with each drop in star ratings.
• While it is acknowledged that there could be several other factors impacting the attrition rates, still the results of this study bring up an important insight into Medicare consumer behavior.