The year 2024 brought about new changes for the MA program that impacted plans’ star ratings and rebates. First, the calculation of MA plans’ quality star ratings changed. One major change was the deletion of outliers in establishing the thresholds that determine ratings. Since these outlier deletions typically exclude extreme low values from the calculation of cut points that determine a plan’s star ratings, this change effectively results in higher thresholds for plans to receive better star ratings. In addition, new measures and weights were given to some ratings. For example, follow-up after an emergency department visit was added as a measure for high-risk people with multiple chronic conditions, and the weight for controlling blood pressure was tripled. As a result of this new star rating calculation, MA plans saw, on average, a decline in health plan performance, with the average rating for MA plans with prescription drug coverage (MA-PD) decreasing from 4.14 to 4.04 and the percentage of MA-PD contracts earning four stars or higher decreasing from 51 percent in 2023 to 42 percent in 2024. Because most of the rebates from star ratings goes toward supplemental benefits, plans had less money to offer supplemental benefits to their members in 2025.

Anderson, A., Higgins, A., Jain, S. H., Meiselbach, M., & Thomas, K. S. (2025). What Recent Changes In MA Mean For Affinity Plans And Supplemental Benefits. Health Affairs Forefront.