For the study, researchers with the Brown University School of Public Health in Providence, R.I., examined a sample of more than 16 million Medicare Advantage enrollees in 515 contracts. Roughly 1.3 million of the enrollees were involved in a consolidation, a process that allows health plans to transfer enrollees to another plan. Most consolidations analyzed in the study were from a lower-rated to plan to a higher-rated one.
The researchers found enrollees who saw a one-star rating increase during this consolidation process were 20.8 percent less likely to choose another coverage option. Additionally, these members were 3.4 percent more likely to use a hospital with a higher star rating. They were 2.6 percent less likely to be readmitted within 90 days, according to the study.
“Overall, our study provides evidence that [Medicare Advantage] contract star ratings capture some important measures of quality and outcomes for enrollees. However, it is unclear whether all of the differences they indicate are clinically meaningful,” the researchers concluded.
More articles on payers:
Blue Shield of California to oversee state’s COVID-19 vaccine distribution
Cigna ends prior authorization for some CT exams
UnitedHealth must redo 67K claims, judge rules
