The Cost of Risk Score and Star Rating Growth: Insights for Future Medicare Advantage Innovation Models

Clicks: 1
ID: 323101
2026
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal

Ranked #77 of 89 articles by views in Health Affairs Scholar

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Abstract
Structured abstract Introduction The Centers for Medicare and Medicaid Services (CMS) may test a new Medicare Advantage (MA) innovation model for achieving broader Medicare efficiency. Informed by the MA Value Based Insurance Design (VBID) model experience, we simulated minimum bid discounts and discussed strategies that would be needed to offset potential costs from plan risk score and star rating growth effects. Methods Using VBID evaluation data, we quantified the challenge CMS faces related to risk score and star ratings growth by calculating simulated payments to plans and bid discounts needed to achieve target savings. Results Had CMS imposed minimum bid discounts (holding model participation constant), we estimated that an average 7% bid discount for VBID plans could have achieved budget neutrality. Alternatively, to achieve 2% CMS savings, VBID would have required 14.5% lower plan bids. Conclusion Small risk score and star rating growth can jeopardize the sustainability and value of MA innovation models, and only a small share of bid discounts pass through to Medicare under MA payment policies. To achieve savings in future MA innovation models, we propose a combination of design features like minimum bid discounts, alternate risk score and star rating methodologies, stop-gap measures, and budget neutrality constraints.
Reference Key
openalex_W7172030906 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Brett Lissenden, Allison Dorneo, John Robst, Peter F. Lyu
Journal Health Affairs Scholar
Year 2026
DOI
10.1093/haschl/qxag199
URL
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

No comments yet. Be the first to comment on this article.