Update on the CMS 2020 Announcment

CMS is changing Star Ratings.  The Member Experience and Access categories are jumping from 1.5x to 2.0x this fall.  That’s significant, but the really big news in the Final Rule released on Friday May 22 (2020) is that they’ll be jumping again to 4x next year.  What will the impact of that move be?  Read on to learn more.

We used CMS’s 2020 Star Ratings data to create a worksheet to recalculate the Star Ratings based on the final rule weight change.  We limited it the 333 plans that had nearly all the measure reported and isolated the calculation to just the weight change (ignoring covid, measure removals, etc. (*) and assumed that all plans will get the same ratings).  This year, plans gain or lose as much as 0.1 point, and next year the range is about 4 times as much.

Some highlights:

• In 2021, most plans are little changed; the largest decrease in raw rating was -0.083 and the largest increase 0.115 on the 5 point stars scale.
• In 2022, this will be much more pronounced.
• Certain states fared better than others. MN, WI, KY and LA plans generally scored higher.
• One particular word in plan names had an interesting correlation, but we didn’t want to call anyone out by name publicly. Plans in New York and California went down more that they.

There’s lots more to see, but we’re sticking to tidbits and offer to share the spreadsheet to anyone else who’s curious.  Email us at: info@baltimorehealthanalytics.com

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