For a third year in a row, we see falling Medicare Advantage Star scores and it signals a major crisis in the industry that needs to be turned around.
About The Podcast:
Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.
Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.
Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.
Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.
Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.
Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.
About The Episode:
On this episode, Marc discusses the 2025 Star Ratings for Medicare Advantage plans. For a third year in a row, we see falling Medicare Advantage Star scores and it signals a major crisis in the industry that needs to be turned around.
Key Takeaways:
Note: This blog is co-produced with Lilac Software, a new technology firm devoted to driving quality and lowering costs in the healthcare system.
Star ratings in 2025 have fallen again – the third year in a row.
2024 and 2025 Star represented very bad news for Medicare Advantage.
The number of contracts scoring 4 Star or greater in 2025 dropped to about 40%.
The number of enrollees forecasted to be in 4 Star or greater contracts is just 62%.
Of 42 measures, 19 dropped on average and just 16 increased on average.
Some of the bad numbers were driven by big plan misses.
But a great deal has to do with the fact that MA plans lost their edge during the COVID years. A lack of focus is driving lower results.
Part of the issue too are more complex measures and Star rules, which will not slow down in the future.
Since 2022, the number of high-performing plans has dropped dramatically.
Star bonuses will drop because of poor 2025 Star results by about $2 billion.
The good news: the Star program is working by challenging plans to get better and better. They need to rise to the occasion.
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Resources
The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance