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 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 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  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.
As finalized in rulemaking in 2020, the 2024 Star Ratings introduced Tukey outlier deletion 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 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.
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. 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.
- 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.
A total of 36 contracts are highlighted on the Medicare Plan Finder with a high performing icon indicating they earned 5 stars; 31 are MA-PD contracts, three are 1876 Cost Contracts, and two are PDPs. For 2024, 11 contracts receiving the high performing icon did not receive it in 2023.
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.
Average Star Rating for Each Measure
Below we list the average Star Ratings for 2021, 2022, 2023, and 2024 Part C and D measures 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 for the 2022 performance period have been applied.