Medicare Stars Plan Preview #2 Data Release

 In the waning hours of September 7^th , 2022, Health Plans received an HPMS memo indicating Plan Preview #2 availability for the Medicare Stars Program. Our team of Stars experts at ProspHire quickly put together a comprehensive data analysis of all cut points across each domain. Although we are still patiently waiting to understand the broader impacts to all health plans, we have some early indications of general performance - with CAHPS and other x4 weighted measures showing decreases in cut points.

HEDIS Performance - Cut Point Analysis

The HEDIS domain displayed inconsistent performance in cut points across most measures. With the lingering impacts of COVID and members forgoing preventative care, we may have anticipated more cut point decreases across the board. In terms of weighting, the x3 weighted Diabetes Blood Sugar measure showed improved performance at the 3-, 4- and 5- Star Level.

HOS Performance - Cut Point Analysis

The HOS domain remains challenging for health plans, with Reducing the Risk of Falling and Improving Bladder Control all showing a decrease in performance across nearly all cut points.

Operations Performance - Cut Point Analysis

The Operations domain (sometimes referred to as Admin domain) showed variable performance across the board. The 4x weighted measures (Call Center, Complaints, Members Leaving Plan) had non-consistent results. Cut point results indicate that there were more complaints in SY23. Additionally, the cut point analysis shows us that less members left their plan in SY23.

Pharmacy Performance - Cut Point Analysis

Following the historical trend, the Pharmacy domain continues to improve year over year. The 3x weighted Medication Adherence measures nearly showed 100% improvement across all cut points. Plans continue to do well in this category, and high-performing Stars Programs will continue to invest time and effort into this domain. 

CAHPS Performance - Cut Point Analysis

As shown on the right-hand side, most measures across all star rating cut points had a drop in the cut point range, indicating that the distribution of CAHPS performance across plans saw a drop in scores from prior year. Despite much investment from Health Plans in member experience, there were no increases in any cut points across all measures.

Are you happy with your Plan Preview #2 data release? At ProspHire, we’ve been supporting Health Plans with their Stars Programs since our inception.