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Association between Medicare Advantage plan star ratings and enrollment
Rachel O Reid1, Partha Deb, Benjamin L Howell
1Centers for Medicare & Medicaid Services, Center for Medicare & Medicaid Innovation, Rapid-Cycle Evaluation Group, Baltimore, MD 21244, USA.
JAMA
|January 17, 2013
Summary
Medicare Advantage star ratings significantly influence enrollment decisions. Higher ratings increase the likelihood of enrollment for both new and switching beneficiaries, though effects vary by demographic group.
Area of Science:
- Health Services Research
- Health Policy
- Consumer Behavior
Background:
- The US Centers for Medicare & Medicaid Services (CMS) uses star ratings to reflect Medicare Advantage (MA) plan quality.
- These ratings are intended to help beneficiaries make informed enrollment choices.
Purpose of the Study:
- To evaluate the association between publicly reported MA plan quality ratings and beneficiary enrollment patterns.
- To understand how MA star ratings impact decisions for both new enrollees and those switching plans.
Main Methods:
- A cross-sectional study analyzed 2011 MA enrollment data.
- Included 952,352 first-time enrollees and 322,699 plan switchers.
- Conditional logit regression modeled the relationship between star ratings and enrollment, controlling for beneficiary and plan characteristics.
Main Results:
- A 1-star increase in MA rating correlated with a 9.5 percentage-point higher likelihood of enrollment for new beneficiaries.
- For switching beneficiaries, a 1-star increase was associated with a 4.4 percentage-point higher likelihood of enrollment.
- The association between star ratings and enrollment was weaker for Black, rural, low-income, and younger beneficiaries.
Conclusions:
- The CMS 5-star rating system for Medicare Advantage plans demonstrably influences beneficiary enrollment decisions.
- Quality ratings serve as a significant factor in plan selection, impacting both initial and subsequent enrollment choices.
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