ArticleJAMA network open2024
Medicare Advantage Plan Star Ratings and County Social Vulnerability.
Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed.
- Prior Authorization Requirements in Medicare Advantage and County Social Vulnerability.The American journal of managed care · 2026Article
- Primary Care Cost Sharing in Medicare Advantage.JAMA health forum · 2026Article
- What is Medicare Advantage and Why is it the Most Important Contemporary Policy Affecting Kidney Disease?American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026Review
- Racial and Ethnic Disparities in Preventive and Chronic Disease Care in Medicare Advantage vs. Traditional Medicare.Journal of general internal medicine · 2026Article
- Association Between Medicare Drug Plan Ratings and Coverage Barriers for Non-Generic, Evidence-Based Cardiovascular Medications.Circulation. Population health and outcomes · 2026Article
- Zero-premium Medicare Advantage plans: trends in areas with socioeconomic vulnerability and health needs.Health affairs scholar · 2025Article
- Cardiovascular Health at the Intersection of Race and Gender in Medicare Fee for Service.JAMA health forum · 2025Article
- Chronic Conditions and Health Care Use Comparison Between Transgender/Gender Diverse and Cisgender Medicare Beneficiaries.Transgender health · 2025Article
- Patient-Reported Characteristics Across Dual-Eligible Medicare Advantage Plan Types.JAMA network open · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: The star rating of a Medicare Advantage (MA) plan is meant to represent plan performance, and it determines the size of quality bonuses. Consumer access to MA plans with a high star rating may vary by the extent of social vulnerability in geographic regions. Objective: To examine the association between a county's Social Vulnerability Index (SVI) and the star rating of a county's MA plans. Design, Setting, and Participants: This cross-sectional study used 2023 Centers for Medicare & Medicaid Services data for all MA plans linked to 2020 county-level SVI data from the Centers for Disease Control and Prevention. Data were analyzed from March to October 2023. Exposure: Quintile rank of county based on composite and theme-specific SVI scores, with quartile 1 (Q1) representing the least vulnerable counties and Q5, the most vulnerable counties. The SVI is a multidimensional measure of a county's social vulnerability across 4 themes: socioeconomic status, household characteristics (such as disability, age, and language), racial and ethnic minority status, and housing type and transportation. Main Outcomes and Measures: County-level mean star rating and the number of MA plans with low-rated (<3.5 stars), high-rated (3.5 or 4.0 stars), and highest-rated (≥4.5 stars) plans. Results: Across 3075 counties, the median county-level star rating was 4.1 (IQR, 3.9-4.3) in Q1 counties and 3.8 (IQR, 3.6-4.0) in Q5 counties (P < .001). The mean star rating of MA plans was lower (difference, -0.24 points; 95% CI, -0.28 to -0.21 points; P < .001), the number of low-rated plans was higher (incidence rate ratio, 1.81; 95% CI, 1.61-2.06; P < .001), and the number of highest-rated plans was lower (incidence rate ratio, 0.75; 95% CI, 0.70-0.81; P < .001) in Q5 counties compared with Q1 counties. Similar patterns were found across theme-specific SVI score quintiles and for 2022 star ratings. Conclusions and Relevance: In this cross-sectional study, the most socially vulnerable counties were found to have the fewest highest-rated plans for MA beneficiaries. As MA enrollment grows in socially vulnerable regions, this may exacerbate regional differences in health outcomes for Medicare beneficiaries.
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