Opportunities to Strengthen the Medicare Advantage Star Ratings Program

December 2017
Full report Executive summary

The Medicare Advantage (MA) Star Ratings program is an example of effectively encouraging quality improvement though payment incentives. Despite its success, there are aspects of the program that could be strengthened to better incentivize and recognize plan improvements.

The MA Star Ratings program is one of several quality incentive programs that link Medicare payments to quality performance. The Star Ratings are one factor in determining plan payment, and may also influence enrollees’ plan selection. Likewise, quality incentive programs are used in fee-for-service (FFS) to reward provider performance and aid beneficiaries’ decisions about where to receive care. However, these programs vary considerably.

This paper compares the MA Star Ratings to FFS quality incentive programs along three dimensions (measure sets, scoring methodology, and transparency of quality information) and makes recommendations to better align the MA Star Ratings program with other Medicare quality incentive programs while continuing to encourage plan quality improvements.

Topics

  • Quality incentive programs in Medicare
  • MA Star Ratings program
  • Comparison of Medicare quality incentive programs:
    • Measure sets
    • Scoring methodology
    • Consumer transparency
  • Recommendations

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