Medicare Star Ratings

The Medicare Advantage (Medicare Part C) and Medicare Part D Star Ratings system was created to provide quality and performance information to help Medicare consumers compare the Medicare Advantage or Prescription Drug Plans offered and assist them in making healthcare decisions that fit their situation. The measurements in the Star Ratings Program are consistent with CMS’s “Meaningful Measures,” which focus on person-centered care, equity, safety, affordability and efficiency, chronic conditions, wellness and prevention, seamless care coordination, and behavioral health. The data collected by Star’s program ranking determination system comes from four sources  — Health and Drug Plans  — Survey of Enrollees  — Data Collected by CMS Contractors — and CMS Administrative Data. It is then presented so individuals can see meaningful information on what individuals receive about a specific plan, alongside that plan’s benefit and cost details. This system collects up to 40 unique quality and performance measures for MA-PD plans, up to 30 measures for MA-only plans, and up to 12 measures for PDP plans. 

The data collected during 2024 is then combined into these five broad categories:

• Outcomes: Outcome measures reflect improvements in a beneficiary’s health and are central to assessing quality of care.
• Intermediate outcomes: Intermediate outcome measures reflect actions that can improve a beneficiary’s health status. Diabetes Care – Blood Sugar Controlled are examples of an intermediate outcome measure where the related outcome of interest would be better health status for beneficiaries with diabetes.
• Patient experience: Patient experience measures reflect beneficiaries’ perspectives of the care they received.
• Access: Access measures reflect processes and issues that could create barriers to receiving needed care. Plan Makes Timely Decisions about Appeals is one example of an access measure.
• Process: Process measures capture the health care services provided to beneficiaries, which can assist in maintaining, monitoring, or improving their health status.

The system uses the data to rank all the measurement points and to create an overall ranking for each plan based on these levels:

The data collected up to the end of December 2024 will show as stars on the Medicare Plan Finder in 2026.