Evaluating the Association Between Medicare Star Ratings Part D Medication Adherence Measures and the Part C Plan All-Cause Readmission Outcome Measure
Author(s)
Eric P. Borrelli, PhD, PharmD, MBA1, Peter Saad, PharmD, MBA2, Nathan E. Barnes, PharmD, MHA2, Kristie Dooley, PharmD2, Julia D. Lucaci, PharmD, MS3.
1Becton, Dickinson and Company, San Diego, CA, USA, 2Becton, Dickinson and Company, Durham, NC, USA, 3Becton, Dickinson and Company, Franklin Lakes, NJ, USA.
1Becton, Dickinson and Company, San Diego, CA, USA, 2Becton, Dickinson and Company, Durham, NC, USA, 3Becton, Dickinson and Company, Franklin Lakes, NJ, USA.
Presentation Documents
OBJECTIVES: To examine the potential interrelation between the 3 Medicare Star Rating (MSR) Part-D medication adherence measures (MAMs) (non-insulin antidiabetics, renin-angiotensin system antagonists (RASA), and statins) and the Part C PACR outcome measure.
METHODS: An analysis of the publicly available annual health plan MSR performance data was conducted to examine the impact of high performance on the 3 Part-D MAMs on performance of the Part-C PACR outcome measure. The analysis assessed MSR years of 2015-2024, except years 2021-2023 where MSR did not include the PACR measure due to the Covid-19 pandemic. The primary outcomes were odds ratios (OR) and 95% confidence intervals (CI) evaluating the likelihood of a health plan achieving at least 4-stars on the PACR measure if it also earned at least 4-stars or 5-stars on the MAM(s) compared to not achieving at least 4-stars or 5-stars on the MAM(s).
RESULTS: Health plans that achieved at least 4-stars or 5-stars on the RASA MAM had significantly higher odds of achieving at least 4-stars on the PACR measure (OR: 1.53, 95% CI:1.30-1.81; OR: 1.51, 95% CI: 1.26-1.81; respectively), as did plans that achieved at least 4-stars or 5-stars on the statin MAM (OR: 1.58, 95% CI: 1.31-1.86; OR: 1.94, 95% CI: 1.55-2.43; respectively), while there was no significant impact for the diabetes MAM (at least 4-stars OR: 1.10, 95% CI: 0.93-1.30; 5-stars OR: 1.09, 95% CI: 0.89-1.33). The likelihood of achieving at least 4-stars on the PACR measure increased non-significantly with the number of MAMs that achieved 5-stars (all 3 MAMs OR: 1.53, 95% CI: 1.17-2.00; 2 MAMs OR: 1.44, 95% CI: 1.09-1.90; 1 MAM OR: 1.11, 95% CI: 0.87-1.41).
CONCLUSIONS: Health plans with higher performance on the MSR MAMs had significantly increased odds of high performance on the MSR PACR measure, suggesting an association between effective medication management and reduced all-cause readmissions.
METHODS: An analysis of the publicly available annual health plan MSR performance data was conducted to examine the impact of high performance on the 3 Part-D MAMs on performance of the Part-C PACR outcome measure. The analysis assessed MSR years of 2015-2024, except years 2021-2023 where MSR did not include the PACR measure due to the Covid-19 pandemic. The primary outcomes were odds ratios (OR) and 95% confidence intervals (CI) evaluating the likelihood of a health plan achieving at least 4-stars on the PACR measure if it also earned at least 4-stars or 5-stars on the MAM(s) compared to not achieving at least 4-stars or 5-stars on the MAM(s).
RESULTS: Health plans that achieved at least 4-stars or 5-stars on the RASA MAM had significantly higher odds of achieving at least 4-stars on the PACR measure (OR: 1.53, 95% CI:1.30-1.81; OR: 1.51, 95% CI: 1.26-1.81; respectively), as did plans that achieved at least 4-stars or 5-stars on the statin MAM (OR: 1.58, 95% CI: 1.31-1.86; OR: 1.94, 95% CI: 1.55-2.43; respectively), while there was no significant impact for the diabetes MAM (at least 4-stars OR: 1.10, 95% CI: 0.93-1.30; 5-stars OR: 1.09, 95% CI: 0.89-1.33). The likelihood of achieving at least 4-stars on the PACR measure increased non-significantly with the number of MAMs that achieved 5-stars (all 3 MAMs OR: 1.53, 95% CI: 1.17-2.00; 2 MAMs OR: 1.44, 95% CI: 1.09-1.90; 1 MAM OR: 1.11, 95% CI: 0.87-1.41).
CONCLUSIONS: Health plans with higher performance on the MSR MAMs had significantly increased odds of high performance on the MSR PACR measure, suggesting an association between effective medication management and reduced all-cause readmissions.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD75
Topic
Health Service Delivery & Process of Care
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Geriatrics