Am J Manag Care. 2025 Nov;31(11):688-692. doi: 10.37765/ajmc.2025.89820.
ABSTRACT
OBJECTIVES: To assess the interrelation between Medicare Star Ratings medication adherence measures and other intermediate and process measures.
STUDY DESIGN: A cross-sectional analysis was performed of the annual Medicare Star Ratings health plan performance data from Star Ratings years 2015-2025. The analysis evaluated the potential relationship between (1) renin-angiotensin system antagonist (RASA) adherence and controlling blood pressure, (2) noninsulin antidiabetic adherence and controlling blood glucose, (3) statin adherence and statin therapy for patients with cardiovascular disease (CVD), and (4) statin adherence and statin use in persons with diabetes (SUPD).
METHODS: The outcomes of interest were ORs and 95% CIs evaluating the likelihood of a health plan achieving 5 stars or at least 4 stars on the intermediate or process measures if they achieved 5 stars or at least 4 stars on the medication adherence measures compared with not achieving 5 stars or at least 4 stars on the medication adherence measures.
RESULTS: Plans that achieved 5 stars on the antidiabetic adherence measure and RASA adherence measure had significantly higher odds of achieving 5 stars on their respective intermediate measures (blood glucose control: OR, 3.50; 95% CI, 2.98-4.12; blood pressure control: OR, 4.61; 95% CI, 3.82-5.60). Plans that achieved 5 stars on the statin adherence measure had significantly higher odds of achieving 5 stars on statin therapy for patients with CVD and SUPD (CVD: OR, 4.68; 95% CI, 3.49-6.27; SUPD: OR, 4.37; 95% CI, 3.26-5.85).
CONCLUSIONS: Medicare Star Ratings medication adherence measures are significantly tied to intermediate and statin process measures. Targeted interventions to improve adherence should be a key strategy for health plans to enhance both clinical outcomes and financial incentives.
PMID:41289258 | DOI:10.37765/ajmc.2025.89820