心血管疾病患者医疗保障星级评估.docxVIP

EvaluatingMedicareStarsfor

cardiovasculardiseasepatients

October2025

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EvaluatingMedicareStarsforCardiovascularDiseasePatients

Contents

Executivesummary 3

1.Introduction 4

1.1TheMedicareStarRatingsprogram 4

1.2CardiovasculardiseaseinMedicareandtheapplicationofStarsRatings 4

1.3CurrentPolicyContext 5

2.Overviewofresearchapproach 6

2.1ApproachtoassessingStarmeasures 6

2.2Approachtoconductingpatientsurvey 7

2.3Approachtoformularyanalysis 7

3.EvaluatingtheMedicareStarsprogram 8

3.1CVDmeasuresanalysis–findings 8

3.2Patientsurvey–findings 9

3.3Formularyanalysis–findings 12

4.Policyrecommendations 13

5.Conclusion 14

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EvaluatingMedicareStarsforCardiovascularDiseasePatients

Executivesummary

Background:AsMedicareenrollmentcontinuestoexpand,andastheearlyeffectsoftheInflationReductionAct(IRA)onaccessandaffordabilitytakeshape,thereisanopportunityfortheMedicareStarRatingsprogramtoplayanimportantroleinincentivizinghealthplanperformance,guiding

beneficiarychoice,andsupportingtheaimsoftheIRA.Giventhatcardiovasculardisease(CVD)

remainstheleadingcauseofdeathintheUnitedStates,particularlyaffectingthegrowingpopulationofMedicarebeneficiaries,therearequestionsastowhetherthecurrentdesignoftheStarRatings

programsufficientlyreflectstheclinicalrealitiesandaccessneedsofpatientswithCVD.

Approach:ToassesstheeffectivenessoftheStarRatingsprogramforCVDpatients,we(1)

undertookareviewofcurrentStarmeasuresrelevanttoCVDcare;(2)fieldedanationalsurveyof

150MedicarebeneficiarieswithCVD;and(3)analyzed5,249MedicarePartDplansintermsoftheircoverageforhigh-useCVDmedications.Together,thesefindingsprovideinsightintothestrengths

andlimitationsofthecu