Which Cupoints are the Hardest to Achieve?

Which CMS MA Star Measures have the hardest cutpoints to achieve?  One can’t just compare the cutpoints directly -- it’s far easier to get 10 more BMIs than 10 more cancer screens. 

There are different ways to answer the question, the simplest is to look at the mean Stars that CMS publishes.  A richer analysis that we find helpful is to use percentiles to normalize the cutpoints across all measures.  Then you can visually compare all cutpoints for all measures at once.

For example the 5 star cutpoint for C04 Improving/Maintaining Physical Health is 72.  Only 18% of plans fell below that mark. 

This compares with C20 Readmissions which has a 5 star cutpoint of 3 that 88% of plans fell short of.  We calculated the percentile as the number of plans with a score below the cutpoint and graphed this for all cutpoints and all measures.  The graph is sorted by the average percentile for the 2,3,4 and 5 star cutpoints.

What we find most interesting is how variable the results are.  Some measures are clearly skewed towards lower star ratings than others. 

This is very different than other ratings systems that set their cutpoints based on specific percentiles.  A second interesting result is that the star lines do not run in parallel.  Some measures have more difficult 4-star cutpoints but easier 5-star cutpoints.

All of these results are based on the published results from CMS for 2020 Star Ratings.  We ran a similar analysis 2 years ago that you can find in our blog. Falls has dropped out of the “most difficult” slot in favor of Readmissions.  From this we can infer a bit about CMS’s priorities as well as where the MA marketplace needs to focus.

The average percentiles for the 2,3,4, and 5 star cutpoints were found to be at the 9^th, 23^rd, 48^th, and 77^th for part C and at the 11^th , 19^th , 40^th  and 67^th for part D respectively.