A Longitudinal Assessment of the Association Between Medicare Advantage Star Ratings and Enrollment

Abstract

Purpose: To assess the association between Medicare Advantage Star Ratings and enrollment decisions of new Medicare Advantage enrollees. Methods: We studied the enrollment decisions of new Medicare Advantage beneficiaries from 2012-2017 using a conditional logistic regression, controlling for plan- and beneficiary-level characteristics. We modeled those who were not previously enrolled in Medicare and those who switched from fee-for-service (FFS) Medicare separately. Results: In the main study cohort, a 1-star increase in Star Rating was associated with a OR 1.88 (95% CI, 1.86-1.89) increase in the likelihood of enrollment among first-time Medicare enrollees and a OR 1.64 (95% CI, 1.55-1.7) increase among those switching from FFS Medicare. The association persisted across all years, though the association was weaker among black, Asian, and older enrollees. Conclusions: Our results indicate that higher Star Ratings is positively associated with likelihood of enrollment for new Medicare Advantage enrollees between 2012-2017.