What is a CMS Star Rating and how should brokers use it when counseling clients?

• A. A measure of provider empathy.
• B. A quality measure of plan performance; higher stars indicate better performance, influencing choice.
• C. A rating of marketing material quality.
• D. A score for member satisfaction that does not affect choices.

Answer: (B)

CMS Star Rating is a quality measure used to rate Medicare Advantage and Part D plans on how well they perform across areas like member experience, access to care, and health outcomes. Ratings run from 1 to 5 stars, with higher stars signaling stronger performance. Brokers should use these ratings as a guide when counseling clients, comparing plans available in the client’s area and highlighting those with higher ratings in areas that matter to the client (such as drug coverage or access to preferred doctors). Keep in mind that a higher rating suggests better quality and service, but it’s one piece of the puzzle—costs, formulary, network, and the client’s specific medications and providers are also critical factors. Star ratings are publicly reported on Medicare.gov, so clients can review them as part of the decision-making process.