How States Can Use Medicare Advantage Star Ratings to Assess D-SNP Quality and Performance

Publisher: Washington, DC, Integrated Care Resource Center
Oct 30, 2018
Authors
Danielle Chelminsky

In reviewing the ratings, note that: 

1. The lowest-ranking plans receive one star, and the highest ranking plans receive five stars. 

2.  Star ratings are assigned at the contract level, not at the individual plan level. A single MA contract may include more than one type of Special Needs Plan (SNP) (i.e., chronic condition, institutional, and/or dual eligible), as well as non-SNP MA plans. A single MA contract may also include plans in more than one state. The star rating assigned to the contract applies to all plans under the contract.

This guide is an overview of the Medicare Advantage (MA) star ratings for calendar year 2019. The Centers for Medicare & Medicaid Services (CMS) publishes the star ratings each year to help beneficiaries find the best plan for them and to determine MA quality bonus payments to plans. States can use the ratings to help assess the plans operating in their state, especially Dual Eligible Special Needs Plans (D-SNPs) with which they may have contracts to provide services to Medicaid beneficiaries.