High-rated Medicare Advantage plans harder to find in more vulnerable areas

Medicare Advantage plans available in the most socially vulnerable counties in the U.S. tend to have lower star ratings than those in less vulnerable counties, a study published July 23 in JAMA Network Open found. 

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The study compared average star ratings in counties based on Social Vulnerability Index scores. The Social Vulnerability Index measures an area’s socioeconomic status, household characteristics, racial and ethnic minority status and housing and transportation. 

In the quintile of least vulnerable counties, the average MA star rating was 4.1. In the most disadvantaged counties, the average rating was 3.8. 

The number of highly-rated plans available was highest in counties in the middle of the Social Vulnerability Index, in the third quintile. The median number of low-rated plans in a county was highest in the most vulnerable areas, and lowest in the most advantaged areas. 

Star ratings determine the bonus payments plans Medicare Advantage plans receive from CMS. Because plans in more disadvantaged areas may be receiving fewer bonus payments, supplemental benefits paid for by bonuses may not be reaching beneficiaries who need them most, the study’s authors wrote. 

“To achieve equity goals, CMS policies should consider local-market social vulnerability when assigning plan star ratings or should systematically raise the benchmarks for vulnerable counties to support plans serving communities with fewer resources,” the study’s authors wrote. 

The study was written by researchers at  New York University and the Brown University School of Public Health in Providence, R.I. 

Read the full study here.

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