Medicare Advantage Plans At Risk Of Losing Quality Bonus

Changes to the Medicare Advantage Star Rating program pose significant headwinds for insurers. The Centers for Medicare and Medicaid Services April 5 published a final rule that will reset the number of plans earning a Star bonus payment and potentially change the composition of winners and losers through the introduction of a new Health Equity Index reward. The changes take hold in measurement year 2024, impacting ratings starting in 2026. Additional changes expected in future rulemaking will compound challenges for Medicare Advantage plans.

Oliver Wyman analyzed the impact that the final rule and...