The recent announcement of 2021 CMS STAR ratings revealed that several MAPD and PDP plans have struggled to keep pace with increasing performance standards and shifting measure weights. In the most recent year, approximately 22% of plans experienced a reduction in overall STAR ratings. Declining performance among Part D measures contributed in large part to a drop in overall STAR ratings and the loss of 4+ STAR ratings by more than thirty plans.
As plans dropped below the 4 STAR threshold, their loss of quality bonus payments (QBPs) will have a significant revenue impact on financial performance. Further loss of 4+ STAR rating may impact membership attrition and growth forecasts. These challenges are just the beginning, as final rule changes to STAR weights will increase the importance of consumer experience driven measures including patient experience and complaint measures as well as measures capturing access. As such, health plans looking to future STAR ratings performance for 2023 and beyond will need to focus more on creating sustainable systems.
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Disruption in the ACA Market – Implications and Strategic Responses
June 11, 2025
In a recent article, A&M Healthcare Industry Group experts explore key policy changes, market dynamics, stakeholder implications and strategic actions for navigating the evolving landscape surrounding the Affordable Care Act marketplace.
The Effect of Trump’s Tariffs on the European Pharmaceutical and Biopharmaceutical Industry
June 9, 2025
As the U.S. considers imposing tariffs on European pharmaceutical imports, the ripple effects could
be felt across the global healthcare landscape.
FORMER FEDERAL HEALTH MINISTER PROFESSOR GREG HUNT JOINS ALVAREZ & MARSAL AUSTRALIA
May 27, 2025
Alvarez & Marsal appoints The Honourable Greg Hunt as a Senior Advisor bolstering its Healthcare and Public Sector advisories in support of maximizing sustainable value for clients.
Contract Research Organisations M&A Market
March 28, 2025
Rising cost pressures, stricter regulatory demands and advancements in emerging therapeutics are intensifying competition within the industry. These dynamics are fuelling the demand for greater efficiency in development lifecycles, creating significant opportunities for outsourced providers like Contract Research Organisations (CROs).
