Lilac Software

Want a quick snapshot of the MA Stars measures that plans were most commonly able to improve and which showed the most declines? Take a look at Marc S. Ryan 🇺🇦's most recent post analyzing Stars data if this kind of benchmarking would be useful for you.

Lilac Software's very own Marc S. Ryan 🇺🇦 shares his next round of insights from our Star data analysis and infographic. This post focuses on some important nuances in how movements at the measure level impacted overall scores (hint: measure weightings mean just as much as measure movements).

Looking for a deeper dive into #MedicareAdvantage Stars data? Check out Marc S. Ryan 🇺🇦's podcast on the The Healthcare Labyrinth. He goes into detail on: ▶ What’s driving the third year in a row of lower Star scores ▶ The types of plans that are performing well and which are struggling ▶ Measure level trends ▶ How plans need to evolve to drive better Star performance It's packed with useful info so give it a listen! https://lnkd.in/ebPBMqNb #MAstars #CMS #healthcare #HEDIS

Continuing my review of Star Year 2025 and past history, Lilac Software’s latest analysis shows that high Star performers suffered the most since 2022, the peak for Star ratings. See the graphic below as well as “Overall Star Ratings Movements” in our Infographic here: https://lnkd.in/eVRcUwwd . How did we determine this? Lilac bundled high performers as 4.5 and 5 Stars, medium performers as 3.5 and 4 Stars, and low performers as 3 Stars and below. We found: ➡ The number and proportion of 4.5 and 5 Star plans have dropped dramatically from 2022 to 2025, going from 168 in 2022 to 92 in 2025, a 45 percent reduction. ➡ For 3.5 and 4 Star plans, the count has increased (from 268 in 2022 to 277 in 2025) but the proportion decreased over the timeframe. ➡ For 3 Star and below plans, the count increased from 27 in 2022 to 146 in 2025, which is a 441% increase. The proportion increased dramatically as well. #cms #stars #medicareadvantage #partd Lilac Software

Continuing my review of Star Year 2025 and past history, Lilac Software’s latest analysis shows that high Star performers suffered the most since 2022, the peak for Star ratings. See the graphic below as well as “Overall Star Ratings Movements” in our Infographic here: https://lnkd.in/eVRcUwwd . How did we determine this? Lilac bundled high performers as 4.5 and 5 Stars, medium performers as 3.5 and 4 Stars, and low performers as 3 Stars and below. We found: ➡ The number and proportion of 4.5 and 5 Star plans have dropped dramatically from 2022 to 2025, going from 168 in 2022 to 92 in 2025, a 45 percent reduction. ➡ For 3.5 and 4 Star plans, the count has increased (from 268 in 2022 to 277 in 2025) but the proportion decreased over the timeframe. ➡ For 3 Star and below plans, the count increased from 27 in 2022 to 146 in 2025, which is a 441% increase. The proportion increased dramatically as well. #cms #stars #medicareadvantage #partd Lilac Software

This is what "It is harder to get a good star rating but quality of care is improving" looks like in a picture when you plot all the data. Statin Use in Persons with Diabetes (or SUPD as we lovingly call it) was introduced in 2019 and score/value performance on this measure has been steadily increasing, however, so have the cut points so Star Ratings have not. This is what Better Care for more people looks like in a picture. Check out today's allotment of the next 4 measures plotted across all contracts across all years and the insights they provide.

Centene has become the latest big Medicare Advantage (MA) plan to sue the Centers for Medicare and Medicaid Services (CMS) over its 2025 Star ratings. United and Humana have already done so. As with the other two plans, Centene argues with CMS’ call center measures. Its complaint raises three fundamental issues: ➡ Relying on a handful of secret shopper calls in a given measure is unreasonable. ➡ The 5-Star score requires 100% of TTY calls to be successfully completed and inclusion of even a single incorrect TTY call in the denominator has significant negative impact. ➡ CMS mishandled and scored one TTY call to Centene’s detriment. Centene says the one call will cost the plan $73 million in revenue. #cms #stars #medicareadvantage Lilac Software

Wow, the Stars lawsuits are flying! We already have United Healthcare and Humana suing CMS. Now, Elevance Health is weighing in on poor Star scores in 2025. A couple of quick points on Elevance: ➡ Elevance sued and won a suit on 2024 Star ratings. ➡ It will see its Star ratings drop in 2025 about as much as United, but not as much as Humana. ➡ It has appealed to CMS on its 2025 ratings but no word back yet. ➡ It improved its performance across 60% of Star measures, but still saw ratings decline due to the rise in cut points. Elevance implies cut points are a bit of a black box as Humana does in its lawsuit. ➡ Elevance's drop in the overall percentage of members in 4 Star or greater plans was tied to one contract missing a 4-Star rating by 0.0004. Wow -- 0.0004! Talk about just missing! With tens of billions at stake, things are getting tense in the industry and with CMS. Elevance CEO Gail Boudreaux said the insurer is “considering all of our options.” That usually translates into a lawsuit. Stay tuned! The Stars roller coaster is off and the twists and turns are already wild! #cms #stars #medicareadvantage Lilac Software

The MA Stars related lawsuits against #CMS keep flowing in. Check out Marc S. Ryan 🇺🇦's breakdown of Humana's 40 page filing. They make some bolder claims around CMS's adherence to the very program they've created. There are many points that have potentially wide reaching implications. Lilac Software will continue to track and synthesize to help make sense of these important developments. Follow to get updates! #medicareadvantage #MAstars #healthcare

Marc S. Ryan 🇺🇦 laid out some of the big takeaways from Lilac's recent infographic on 2025 MA Stars data. Our data science team helped tease out meaningful movements in the data and Marc shares his analysis and commentary on: ➡ Overall MA-PD trends ➡ Changes in number of low, medium and high performing plans ➡ Overall measure trends ➡ Measures that move the most and are stickiest Marc's article can be found here: https://lnkd.in/e4sU6HA9 And you can find the full infographic here: https://lnkd.in/eh8MhvZ3 #medicareadvantage #MAstars #CMS #healthtech