News: MA star ratings published for 2025, leading insurers see year-over-year decrease

This week, CMS has published the Medicare Advantage (Medicare Part C) and Medicare Part D 2025 Star Ratings. These ratings are used to measure the quality of health and prescription drug services received by consumers enrolled in MA and Part D prescription drug plans, and this year only minor methodological changes were implemented (such as increasing the weight for the Part C Plan All-Cause Readmissions measure from one to three).

Leading insurers experienced a 0.23 year-over-year decrease in their star ratings, according to an analysis by HealthScape Advisors. For instance, UnitedHealth’s average star rating decreased by 0.39, and Humana saw the largest drop at 0.74 year-over-year, Fierce Healthcare reported. Blue Cross Blue Shield (BCBS) Florida (Guidewell) and BCBS Minnesota also experienced significant drops. On the other hand, Alignment Healthcare and Clover Health, which both saw an increase in rating.

“Plans that earn 4 stars receive a 5% increase in their benchmark as a quality bonus payment,” HealthScape authors said in their report. “Moving from 4.5 to 5 stars does not provide a rebate or quality bonus payment advantage. However, plans with 5 stars have a strategic advantage of marketing their products year-round, not just during the short open enrollment period in October through December.”

In 2024, 62% of membership can be attributed to a plan with a star rating of at least four, compared to 79% in 2023. Only 1.8% of membership is now in a 5-star plan, down from nearly 8% the prior year and 27% in 2022. CMS noted that numerous factors influenced changes in measure level cut points, though some plans have voice intentions to contest their results.

Editor’s note: To read Fierce Healthcare’s coverage of this story, click here. To read HealthScape Advisors’ analysis, click here. To access the CMS fact sheet, click here.