Star Ratings Surge Could Disrupt the Market During Special Enrollment Period

The pandemic-fueled boom in 5-star rated Medicare Advantage contracts could cause “significant market disruption” in 2022, suggests a new report from Wakely. In an analysis of enrollment data from CMS, the actuarial consulting firm found that 5-star contracts account for 19% to 30% of MA intra-year enrollment growth (i.e., enrollment gains occurring between February and December of a particular year), with 5-star contracts growing between 3.8% and 5.1% midyear. Since 5-star plans have the advantage of marketing their products all year long and enrolling members who qualify for the 5-star special enrollment period, the major increase in the number of available 5-star plans has the potential to create unprecedented enrollment shifts later this year. The report warned, however, that midyear plan switchers may have a less-than-favorable risk profile.