Creating a Sustainable Part D STAR Ratings Program
The recent announcement of 2021 CMS STAR ratings revealed that several MAPD and PDP plans have struggled to keep pace with increasing performance standards and shifting measure weights. In the most recent year, approximately 22% of plans experienced a reduction in overall STAR ratings. Declining performance among Part D measures contributed in large part to a drop in overall STAR ratings and the loss of 4+ STAR ratings by more than thirty plans.
As plans dropped below the 4 STAR threshold, their loss of quality bonus payments (QBPs) will have a significant revenue impact on financial performance. Further loss of 4+ STAR rating may impact membership attrition and growth forecasts. These challenges are just the beginning, as final rule changes to STAR weights will increase the importance of consumer experience driven measures including patient experience and complaint measures as well as measures capturing access. As such, health plans looking to future STAR ratings performance for 2023 and beyond will need to focus more on creating sustainable systems.
