The Relationship Between Medicare Advantage Star Ratings and Enrollee Experience.
J Gen Intern Med
; 36(12): 3704-3710, 2021 12.
Article
em En
| MEDLINE
| ID: mdl-33846937
ABSTRACT
BACKGROUND:
Medicare Advantage plans, private managed care plans that enrolled 34% of Medicare beneficiaries in 2019, received $6 billion in annual bonus payments on the basis of their performance on a 5-star rating system. Little is known, however, as to the extent these ratings adequately capture enrollee experience.OBJECTIVES:
To measure the effect of exposure to higher rated Medicare Advantage contracts on enrollee experience.DESIGN:
An instrumental variables analysis using MA contract consolidation as an exogenous shock to the quality of plan enrollees are exposed to.PARTICIPANTS:
A total of 345,897 MA enrollees enrolled in non-consolidated contracts and 21,405 enrollees who were consolidated. MAINMEASURES:
The primary exposure was enrollee star rating, instrumented using contract consolidation. The primary outcomes were enrollee self-reported experience measures. KEYRESULTS:
There were no significant effects on increased star ratings on 23 of 27 outcomes. A one-star increase in contract star rating leads to a 5.4 percentage point increase in reporting that pain does not interfere with daily activities (95%CI 2.4, 8.4), and a 4.4 percentage reduction in the likelihood that a physician would talk to the enrollee about physical activity (95%CI -7.8, -1.1, all p<0.05). A one-star increase in contract star rating led to an 8.4 percentage point reduction in achieving the top score on the received needed information index (95%CI -16.4, -0.4), and a 1.8 percentage point reduction in responding with the lowest score for the overall rating of care (95%CI -3.5, -0.1).CONCLUSIONS:
Exposure to a higher rated MA contract did not appreciably increase enrollee experience. Policymakers should consider reassessing how these ratings and associated bonus payments are currently calculated.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Medicare Part C
Limite:
Aged
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article