STAT+: Medicare Advantage plans to gain $13 billion under Trump changes to star ratings
Medicare Advantage insurers scored a Thanksgiving gift, as President Trump’s Medicare agency added back a bonus system that rewards health plans with consistently high marks.
The Centers for Medicare and Medicaid Services also is proposing to eliminate a dozen star ratings measures that it deemed too administrative. Notably, one of those star ratings measures focuses on the performance of an insurance company’s call centers — the exact metric that Humana and UnitedHealth Group have sued over, alleging that CMS unfairly downgraded them because of missed phone calls.
Medicare said the changes would cost taxpayers $13.2 billion between 2028 and 2036, as more insurers get higher star ratings and bonus payments. That’s a relatively small amount of money for the Medicare Advantage program, which is expected to cost more than $750 billion just in 2028. But it still amounts to large extra sums for individual health insurers that are looking to boost their slimmed-down Medicare profit margins.
Bob Herman
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