Reward Factor Trends and 2025 Star ratings projections

Medicare Advantage Star Ratings PP2 Cutpoints are out, and the final 2025 Star Ratings are scheduled to release in October, ahead of the AEP. Many in the industry are wondering what we can tell now from the available data about how the 2025 Stars average scores and average industry performance will look.

BHA analyzed historical RF percentile thresholds and compared them with the Stars average scores (average scores and weighted average scores).

2025 Plan Preview 2 Cutpoints

CMS recently released the annual memo “Second Plan Preview of 2025 Part C and D Star Ratings Data” on 9/5 announcing that the second Plan Preview will start 9/6 and run through 9/13.

BHA has analyzed and compared the newly available 2025 Cutpoints with the previous year. 

Introduction

CMS recently released the CY 2025 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies Advance Notice. BHA would like to share a quick sumary from stars lens.

Net Payment Impact

What is the HEI?

 The HEI is a proposed bonus ranging from 0 to 0.4 added directly to each plan’s raw star rating based on two things: (1) the percentage of members that either are disabled or have Low Incoming Subsidy or Dual Eligibility, and (2) the number of measures in which the plan scored well for this subset of members.

Please navigate to https://baltimorehealthanalytics.com/websiteblog/tutorial/health-equity-index to read the full content!

Medicare Advantage: Unveiling the 2025 Proposed Rule by CMS! 

The Centers for Medicare & Medicaid Services (CMS) recently released the 2025 Medicare Advantage (MA) Proposed Rule.

In the proposed Rule places a spotlight on critical aspects, demonstrating CMS's commitment to improving health equity, restricting broker marketing practices, and expanding access to behavioral health services. We also saw some important announcements related to Star ratings!

Diving into the proposed Stars changes: What You