In November CMS released it’s report – Trends in Part C & D STAR measure rating cut points (https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/Downloads/2017-Trends-in-Part-C-and-D-Star-Ratings-Cut-Points.pdf) . To be sure, this report provides a lot of data regarding the STAR cut points, but CMS does not accompany the data with a ton of insight.
General STAR Trends
The primary insight to be derived from this report is a general sense of how almost all STAR measures trend. We all try to gage how much we will have to improve a particular measure to achieve a certain STAR level. This report provides that type of insight. For almost any STAR measure:
- The 5 STAR cut points remain relatively constant
- Plans achieving 4 STAR cut points trend a bit slower, but eventually level off a few percentage points below a 5 STAR plan
- From year to year there is a great deal of variability at the 2 and 3 STAR cut points.
CMR STAR Rates
These general trends are especially poignant for the MTM program. With respect to the CMR rate 5 STAR cut points were 76% in 2016 and 76.8% for 2017. The trend for 4 STAR cut points a bit steeper with cut points in 2016 at 48.6% and for 2017 58.1%. Based on the trend for other STAR measures one might expect the 4 STAR cut point to increase in 2018, albeit not as drastically as it did over the 2016-2017 period. The largest increase in trend can be seen in the 2 STAR cut points with cut points increasing from 13.6% in 2016 to 33.2% for 2017. Again based on the trend in other STAR measures it would be “any one’s guess” if the cut points at the 2 STAR level either increase or decrease.
Note: Remember the cut points released in a particular year are for the program which closed 2 years ago
James Notaro, RPh, PhD