Workweek October 10, 2022
Every year, CMS releases star ratings (AKA the Google Reviews of health insurance plans for seniors). The star ratings are based on a variety of inputs that are supposed to reflect the experiences of the consumers that had those plans in the past. It’s a big deal for plans to get a 4-star or higher plan, since CMS issues a 5% quality bonus for plans above that threshold. Given how much revenue is at stake in MA coverage, a 5% drop is a BFD. 2023 star ratings will affect 2024 revenue.
For 2023, a significant number of plans received downgrades for two main reasons.
- One – CMS removed ‘guardrails’ in effect from the public health emergency that prevented major...
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