The Centers for Medicare & Medicaid Services has recalculated star ratings for Medicare Advantage plans for another time, injecting fresh volatility into the program. This move comes amid ongoing industry lawsuits and uncertainty over bonus payments.
Plans earning four out of five stars or higher receive bonus payments, which have swelled to $16 billion this year. The recalculation could shift which plans qualify for these lucrative bonuses, altering competitive dynamics.
The adjustment follows a pattern of frequent changes that industry groups argue undermines predictability for both insurers and beneficiaries. Critics say the volatility makes long-term planning difficult and may ultimately affect patient access and plan offerings.
For insurers, each star-rating change can mean millions in lost or gained revenue. Beneficiaries may see shifts in plan benefits or premiums as companies adjust to new ratings.
The industry has pushed back through lawsuits and lobbying, arguing the process lacks transparency and consistency. CMS maintains the recalibrations are necessary to ensure accuracy and program integrity.