Fact Sheets Oct 13, 2023

2024 Medicare Advantage and Part D Star Ratings

Note: The information included in this Fact Sheet is based on the 2024 Star Ratings published on the Medicare Plan Finder on October 13, 2023. For details on the Medicare Advantage (MA) and Part D Star Ratings, please refer to the 2024 Part C & D Star Ratings Technical Notes available at http://go.cms.gov/partcanddstarratings.

Introduction

The Centers for Medicare & Medicaid Services (CMS) publishes the Medicare Advantage (Medicare Part C) and Medicare Part D Star Ratings each year to measure the quality of health and drug services received by consumers enrolled in Medicare Advantage (MA) and Prescription Drug Plans (PDPs or Part D plans). The Star Ratings system helps Medicare consumers compare the quality of Medicare health and drug plans being offered so they are empowered to make the best health care decisions for them. An important component of this effort is to provide Medicare consumers and their caregivers with meaningful information about quality alongside information about benefits and costs to assist them in being informed and active health care consumers.

Highlights of Contract Performance in 2024 Star Ratings

Changes in the Methodology for the 2024 Star Ratings

Medicare Advantage with prescription drug (Part D) coverage (MA-PD) contracts are rated on up to 40 unique quality and performance measures; MA-only contracts (without Part D coverage) are rated on up to 30 measures; and PDP contracts are rated on up to 12 measures. As finalized in previous rulemaking, the updated Plan All-Cause Readmissions (Part C) measure [1] was re-specified and transitioned off the display page into the 2024 Star Ratings as a new measure with a weight of 1 for the first year. Starting with the 2024 Star Ratings, the Diabetes Care – Kidney Disease Monitoring (Part C) measure [2] was retired, and both the Transitions of Care (Part C) and Follow-Up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (Part C) measures [3] were added to the 2024 Star Ratings, each with a weight of 1. The weight for the Part C Controlling Blood Pressure measure was increased from 1 to 3 [4]. 

As finalized in rulemaking in 2020, the 2024 Star Ratings introduced Tukey outlier deletion [5] when calculating the cut points for all non-Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures in order to improve predictability and stability in the Star Ratings. Tukey outlier deletion involves removing outlier contract scores prior to applying mean resampling within the hierarchical clustering algorithm to determine measure-level cut points.  

Data integrity issues are now included in the description of missing data [6] in the extreme and uncontrollable circumstance (disaster) policy. For disaster-affected contracts with a data integrity issue, the final measure rating is based on the current year.

Rating Distribution [7]

The last row in Table 1 shows the trend in the average overall Star Ratings weighted by enrollment for MA-PDs from 2021 to 2024 after any adjustments for extreme and uncontrollable circumstances. [10]  The change in distribution from 2023 to 2024 Star Ratings is influenced by changes in measure scores in both positive and negative directions based on contract performance and the introduction of Tukey outlier deletion as well as the addition of two new Part C measures (Transitions of Care and Follow-Up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions), adding back the Plan All-Cause Readmissions (Part C) measure after a substantive change in the measure specification, and retiring the Diabetes Care – Kidney Disease Monitoring (Part C) measure.

  • Approximately 42% of MA-PDs (229 contracts) that will be offered in 2024 earned 4 stars or higher for their 2024 overall rating.
  • Weighted by enrollment, approximately 74% of MA-PD enrollees are currently in contracts that will have 4 or more stars in 2024.
Table 1: 2021 - 2024 Overall Star Rating Distribution for MA-PD Contracts

Overall Rating 

2021

2022

2023

2024

# of Contracts

%

Weighted by Enrollment

# of Contracts

%

Weighted by Enrollment

# of Contracts

%

Weighted by Enrollment

# of Contracts

%

Weighted by Enrollment

5 stars

21

5.25

9.15

74

15.71

26.59

57

11.24

21.87

31

5.69

6.96

4.5 stars

63

15.75

21.92

96

20.38

33.21

67

13.21

25.92

75

13.76

30.90

4 stars

110

27.50

45.76

152

32.27

29.87

136

26.82

24.26

123

22.57

35.86

3.5 stars

141

35.25

18.97

122

25.90

8.49

116

22.88

18.71

138

25.32

17.79

3 stars

61

15.25

4.14

25

5.31

1.80

90

17.75

6.73

128

23.49

7.05

2.5 stars

4

1.00

0.06

2

0.42

0.03

37

7.30

2.39

46

8.44

1.41

2 stars

0

0

0

0

0

0

4

0.79

0.12

4

0.73

0.03

Total Rated Contracts

400

100

 

471

100

 

507

100

 

545

100

 

Average Star Rating*

4.06

4.37

4.14

4.04

* The average Star Rating is weighted by enrollment.

The last row in Table 2 shows the average Part D Ratings weighted by enrollment for stand-alone PDPs from 2021 to 2024 after any adjustments for extreme and uncontrollable circumstances. [10]

  • Approximately 27% of PDPs (13 contracts) that will be active in 2024 received 4 or more stars for their 2024 Part D Rating.

  • Weighted by enrollment, about 2 percent of PDP enrollees are currently in contracts that will have 4 or more stars in 2024.

Table 2

 

5-Star Contracts

A total of 36 contracts are highlighted on the Medicare Plan Finder with a high performing icon [8] indicating they earned 5 stars; 31 are MA-PD contracts (Table A1 in Appendix), three are 1876 Cost Contracts (Table A2 in Appendix), and two are PDPs (Table A3 in Appendix). For 2024, 11 contracts receiving the high performing icon did not receive it in 2023. 

Consistently Low Performers

There are six contracts identified on the Medicare Plan Finder with a low performing icon [9] for 2024 for consistently low quality ratings (Table A4 in Appendix). Last year, one contract received this icon.

Tax Status and Performance

Organizations that are non-profit more frequently earn higher ratings than organizations that are for-profit. For MA-PDs, approximately 56% of non-profit contracts received 4 or more stars compared to 36% of for-profit MA-PDs. Similarly, for PDPs, approximately 50% of non-profit PDPs received 4 or more stars compared to 14% of for-profit PDPs. 

Below is the ratings distribution by tax status for MA-PD (Table 3) and PDP (Table 4) contracts after any adjustments for extreme and uncontrollable circumstances. [10]

Table 3: Distribution of 2024 Overall Star Ratings for For-profit and Non-profit MA-PDs

2024 Overall Rating

Count

For-Profit

% For-Profit

Weighted By Enrollment For-Profit

Count Non-Profit

% Non-Profit

Weighted By Enrollment Non-Profit

5 stars

25

6.41

8.07

6

3.87

3.37

4.5 stars

35

8.97

32.46

40

25.81

25.84

4 stars

82

21.03

32.54

41

26.45

46.64

3.5 stars

96

24.62

17.34

42

27.10

19.26

3 stars

106

27.18

7.84

22

14.19

4.47

2.5 stars

42

10.77

1.72

4

2.58

0.41

2 stars

4

1.03

0.03

0

0

Total Rated Contracts

340

 

 

155

 

 

Table 4: Distribution of 2024 Part D Ratings for For-profit and Non-profit PDPs

2024 Part D Rating

Count

For-Profit

% For-Profit

Weighted By Enrollment For-Profit

Count

Non-Profit

% Non-Profit

Weighted By Enrollment Non-Profit

5 stars

0

0

0

2

11.11

1.64

4.5 stars

0

0

0

4

22.22

22.96

4 stars

4

13.79

0.60

3

16.67

31.18

3.5 stars

7

24.14

33.19

3

16.67

11.63

3 stars

10

34.48

54.85

5

27.78

30.57

2.5 stars

3

10.34

8.81

0

0

0

2 stars

3

10.34

0.06

1

5.56

2.01

1.5 stars

2

6.90

2.49

0

0

0

Total Rated Contracts

29

 

 

18

 

 

Length of Time in Program and Performance

Generally, higher overall Star Ratings are associated with contracts that have more experience in the MA program. MA-PDs with 10 or more years in the program are more likely to have 4 or more stars compared to contracts with less than 5 years in the program. For PDPs, the relationship is similar in that PDPs with 10 or more years in the program do better in the Star Ratings relative to contracts with less than 5 years experience. There are only three PDPs that have at least 5 years but less than 10 years of experience and two of the three received 4 or more stars.  The tables below show the distribution of ratings by the number of years in the program (MA-PDs are shown in Table 5 and PDPs in Table 6 after adjustments for extreme and uncontrollable circumstances). [10]

Table 5: Distribution of 2024 Overall Star Ratings by Length of Time in Program for MA-PDs

2024 Overall Rating

Number of Contracts with less than 5 Years

% Less than 5 Years

Number of Contracts with 5 years to Less than 10 Years

% 5 Years to Less than 10 Years

Number of Contracts with 10 or More Years

% 10 or More Years

5 stars

6

3.53

3

2.86

22

8.15

4.5 stars

16

9.41

11

10.48

48

17.78

4 stars

24

14.12

27

25.71

72

26.67

3.5 stars

43

25.29

28

26.67

67

24.81

3 stars

50

29.41

31

29.52

47

17.41

2.5 stars

28

16.47

4

3.81

14

5.19

2 stars

3

1.76

1

0.95

0

0

Total Rated Contracts

170

 

105

 

270

 

Table 6: Distribution of 2024 Part D Ratings by Length of Time in Program for PDPs

2024 Part D Rating

Number of Contracts with less than 5 Years

% Less than 5 Years

Number of Contracts with 5 years to Less than 10 Years

% 5 Years to Less than 10 Years

Number of Contracts with 10 or More Years

% 10 or More Years

5 stars

0

0

1

33.33

1

2.38

4.5 stars

0

0

0

0

4

9.52

4 stars

0

0

1

33.33

6

14.29

3.5 stars

1

33.33

0

0

9

21.43

3 stars

0

0

0

0

16

38.10

2.5 stars

0

0

0

0

3

7.14

2 stars

0

0

1

33.33

3

7.14

1.5 stars

2

66.67

0

0

0

0

Total Rated Contracts

3

 

3

 

42

 

Average Star Rating for Each Measure

Below we list the average Star Ratings for 2021, 2022, 2023, and 2024 Part C and D measures (Tables 7, 8, and 9) using all measure scores for contracts that are publicly reported in a given year. All Star Ratings referenced in Tables 7, 8, and 9 are after adjustments for extreme and uncontrollable circumstances triggered by the COVID-19 public health emergency (PHE) for the 2022 Star Ratings for non-Health Outcomes Survey (HOS) measures and for the 2023 Star Ratings for HOS measures, and after adjustments for other qualifying extreme and uncontrollable circumstances [10] for the 2022 performance period have been applied.

Table 7: 2021 - 2024 Average Star Rating by Part C Measure

Measure

2021 Average Star

2022 Average Star

2023 Average Star

2024 Average Star

Breast Cancer Screening

3.5

3.9

3.7

3.7

Colorectal Cancer Screening

3.9

3.9

3.8

3.7

Annual Flu Vaccine

3.2

3.4

3.2

3.1

Monitoring Physical Activity

3.5

3.1

3.2

3.0

Special Needs Plan (SNP) Care Management

3.4

3.6

3.3

3.4

Care for Older Adults – Medication Review

4.3

4.4

4.4

3.8

Care for Older Adults – Pain Assessment

4.5

4.4

4.3

3.9

Osteoporosis Management in Women who had a Fracture

3.1

3.1

2.6

2.6

Diabetes Care – Eye Exam

3.8

3.8

3.7

3.5

Diabetes Care – Blood Sugar Controlled

4.2

4.3

4.1

3.6

Controlling Blood Pressure

NA

NA

3.5

3.4

Reducing the Risk of Falling

3.0

2.5

2.9

2.9

Improving Bladder Control

3.2

2.7

3.3

3.2

Medication Reconciliation Post-Discharge

3.0

3.5

3.4

3.4

Plan All-Cause Readmissions

NA

NA

NA

2.9

Statin Therapy for Patients with Cardiovascular Disease

3.1

3.5

3.5

3.3

Transitions of Care

NA

NA

NA

2.5

Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions

NA

NA

NA

3.0

Getting Needed Care

3.3

3.6

3.4

3.4

Getting Appointments and Care Quickly

3.4

3.6

3.5

3.5

Customer Service

3.5

3.8

3.4

3.6

Rating of Health Care Quality

3.3

3.6

3.4

3.3

Rating of Health Plan

3.2

3.5

3.2

3.1

Care Coordination

3.4

3.7

3.5

3.6

Complaints about the Plan

4.8

4.7

4.3

3.9

Members Choosing to Leave the Plan

4.0

4.1

3.5

3.6

Health Plan Quality Improvement

3.2

3.7

2.6

3.0

Plan Makes Timely Decisions about Appeals

4.3

4.6

4.6.

4.1

Reviewing Appeals Decisions

4.5

4.6

4.4

3.6

Call Center – Foreign Language Interpreter and TTY Availability

4.3

4.6

4.3

4.3

Table 8: 2021 - 2024 Average Star Rating by Part D Measure for MA-PDs

Measure

2021 MA-PD Average Star

2022 MA-PD Average Star

2023 MA-PD Average Star

2024 MA-PD Average Star

Call Center – Foreign Language Interpreter and TTY Availability

4.4

4.5

4.4

3.7

Complaints about the Plan

4.8

4.7

4.3

3.9

Members Choosing to Leave the Plan

4.0

4.1

3.5

3.6

Drug Plan Quality Improvement

3.5

4.2

2.7

3.4

Rating of Drug Plan

3.0

3.4

3.2

3.2

Getting Needed Prescription Drugs

3.5

3.8

3.4

3.5

MPF Price Accuracy

4.9

4.0

4.2

3.6

Medication Adherence for Diabetes Medications

3.7

3.7

3.0

3.3

Medication Adherence for Hypertension (RAS antagonists)

3.2

3.9

3.4

3.4

Medication Adherence for Cholesterol (Statins)

3.3

3.6

3.1

3.2

MTM Program Completion Rate for CMR

3.7

4.0

3.9

3.5

Statin Use in Persons with Diabetes (SUPD)

3.1

3.4

3.1

2.7

Table 9: 2021 - 2024 Average Star Rating by Part D Measure for PDPs

Measure

2021 PDP Average Star

2022 PDP Average Star

2023 PDP Average Star

2024 PDP Average Star

Call Center – Foreign Language Interpreter and TTY Availability

4.2

4.2

4.1

3.0

Complaints about the Plan

4.9

4.8

4.4

3.9

Members Choosing to Leave the Plan

4.1

4.2

4.0

3.8

Drug Plan Quality Improvement

4.1

4.1

2.2

2.9

Rating of Drug Plan

3.5

3.8

3.3

3.4

Getting Needed Prescription Drugs

3.6

3.9

3.5

3.5

MPF Price Accuracy

4.9

3.3

3.5

3.6

Medication Adherence for Diabetes Medications

3.9

3.9

2.9

2.6

Medication Adherence for Hypertension (RAS antagonists)

3.1

3.5

2.7

2.6

Medication Adherence for Cholesterol (Statins)

3.6

3.6

3.1

3.0

MTM Program Completion Rate for CMR

3.6

3.7

3.1

3.2

Statin Use in Persons with Diabetes (SUPD)

3.0

3.3

2.9

2.4

 

APPENDIX

Table A1:  MA-PD Contracts Receiving the 2024 High Performing Icon

Contract ID

Contract Name

Parent Organization

9/2023

Enrollment

5 Star Last Year

Includes SNP Plan Benefit Packages

H0154

VIVA HEALTH, INC.

Triton Health Systems, L.L.C.

54,211

Yes

Yes

H0169

UNITEDHEALTHCARE OF WISCONSIN, INC.

UnitedHealth Group, Inc.

90,554

No

Yes

H0292

HUMANA HEALTH PLAN OF OHIO, INC.

Humana Inc.

10,217

Yes

No

H0332

KS PLAN ADMINISTRATORS, LLC

UnitedHealth Group, Inc.

49,331

Yes

No

H0710

CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.

UnitedHealth Group, Inc.

49,125

Yes

Yes

H1036

HUMANA MEDICAL PLAN, INC.

Humana Inc.

602,593

No

Yes

H1290

DEVOTED HEALTH PLAN OF FLORIDA, INC.

Devoted Health, Inc.

35,402

No

Yes

H1537

CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.

UnitedHealth Group, Inc.

8,965

Yes

No

H1961

PEOPLES HEALTH, INC.

UnitedHealth Group, Inc.

97,472

Yes

Yes

H1994

SELECTHEALTH, INC.

Intermountain Health Care, Inc.

47,705

Yes

Yes

H2292

CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.

UnitedHealth Group, Inc.

9,608

Yes

Yes

H2610

ESSENCE HEALTHCARE, INC.

Lumeris Group Holdings Corporation

55,027

Yes

No

H2697

DEVOTED HEALTH PLAN OF OHIO, INC.

Devoted Health, Inc.

22,137

Yes

Yes

H3344

INDEPENDENT HEALTH BENEFITS CORPORATION

Independent Health Association, Inc.

4,943

Yes

No

H3362

INDEPENDENT HEALTH ASSOCIATION, INC.

Independent Health Association, Inc.

61,341

Yes

Yes

H3664

AULTCARE HEALTH INSURING CORPORATION

Aultman Health Foundation

14,078

Yes

No

H3907

UPMC HEALTH PLAN, INC.

UPMC Health System

148,511

Yes

No

H3957

HIGHMARK CHOICE COMPANY

Highmark Health

58,410

Yes

No

H4172

NHC ADVANTAGE, LLC

Missouri Healthcare Advisors, LLC

1,200

No

Yes

H4286

LEON HEALTH, INC.

Leon Health Holdings, LLC

39,137

No

Yes

H4461

CARITEN HEALTH PLAN INC.

Humana Inc.

166,542

Yes

Yes

H5215

NETWORK HEALTH INSURANCE CORPORATION

Network Health, Inc.

69,727

Yes

Yes

H5420

Preferred Care Network, Inc.

UnitedHealth Group, Inc.

39,879

No

Yes

H5471

SIMPLY HEALTHCARE PLANS, INC.

Elevance Health, Inc.

60,723

No

Yes

H5533

UPMC HEALTH NETWORK, INC.

UPMC Health System

18,950

Yes

No

H5577

MCS ADVANTAGE, INC.

MHH Healthcare, L.P.

207,906

No

Yes

H5594

OPTIMUM HEALTHCARE, INC.

Elevance Health, Inc.

59,431

Yes

Yes

H5652

SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.

UnitedHealth Group, Inc.

6,007

Yes

Yes

H7617

EMPHESYS INSURANCE COMPANY

Humana Inc.

10,662

No

No

H9153

WEST VIRGINIA SENIOR ADVANTAGE, INC.

SNP Holdings, LLC

852

No

Yes

H9834

QUARTZ HEALTH PLAN MN CORPORATION

University of Wisconsin Hospitals and Clincs Autho

3,598

Yes

No

Table A2: 1876 Cost Contracts Receiving the 2024 High Performing Icon*

Contract ID

Contract Name

Parent Organization

9/2023

Enrollment

5 Star Last Year

H1651

MEDICAL ASSOCIATES HEALTH PLAN, INC.

Medical Associates Clinic, P.C.

15,046

Yes

H5256

MEDICAL ASSOCIATES CLINIC HEALTH PLAN

Medical Associates Clinic, P.C.

3,728

Yes

H5264

DEAN HEALTH PLAN, INC.

Medica Holding Company

13,409

Yes

*1876 Cost Contracts do not offer SNPs

Table A3: PDP Contracts Receiving the 2024 High Performing Icon

Contract ID

Contract Name

Parent Organization

9/2023

Enrollment

5 Star Last Year

S1822

HEALTHPARTNERS, INC.

HealthPartners, Inc.

2,404

No

S4501

INDEPENDENT HEALTH BENEFITS CORPORATION

Independent Health Association, Inc.

7,268

Yes

Table A4: Contracts Receiving the Low Performing Icon for the 2024 Star Ratings

Contract ID

Contract Name

Parent Organization

Reason for Low Performance Warning

9/2023 Enrollment

H0724

BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc.

Centene Corporation

Part C or D

1,900

H5199

WELLCARE HEALTH INSURANCE OF ARIZONA, INC.

Centene Corporation

Part C

9,808

H6446

SILVERSUMMIT HEALTHPLAN, INC.

Centene Corporation

Part C or D

3,343

H7175

WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.

Centene Corporation

Part C

9.062

H7330

ZING HEALTH, INC.

Zing Health Consolidator, Inc

Part D

2,215

S6946

CLEAR SPRING HEALTH INSURANCE COMPANY

Group 1001

Part D

454,820

 


[1] See CY 2020 and 2021 final rule (CMS-4185-F) at https://www.federalregister.gov/documents/2019/04/16/2019-06822/medicare-and-medicaid-programs-policy-and-technical-changes-to-the-medicare-advantage-medicare. See also the Announcement of Calendar Year (CY) 2022 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, page 97 at https://www.cms.gov/files/document/2022-announcement.pdf.  

[4] See also the Announcement of Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, page 145 at https://www.cms.gov/files/document/2024-announcement-pdf.pdf.  

[5] See CY 2021 final rule (CMS-4190-F) at https://www.federalregister.gov/documents/2020/06/02/2020-11342/medicare-program-contract-year-2021-policy-and-technical-changes-to-the-medicare-advantage-program; and December 19, 2022, HPMS Memorandum “Part C and D Star Ratings Tukey Outlier Deletion Simulations”

[7] Percentages in the tables may not sum to 100 due to rounding.

[8] 42 C.F.R. §§ 422.166(h)(1)(i), 423.186(h)(1(i).

[9] 42 C.F.R. §§ 422.166(h)(1)(ii), 423.186(h)(1)(ii).

[10] The qualifying extreme and uncontrollable circumstances for the 2022 performance period include New Mexico wildfires, Kentucky severe storms, Hurricane Fiona, and Hurricane Ian.  See 2024 Rate Announcement at https://www.cms.gov/files/document/2024-announcement-pdf.pdf.