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As participation in Medicare Advantage and Part D increasingly hinges on Medicare’s star ratings for quality – and CMS adjusts the weights and measures used in determining star ratings – even plans that had successful star-ratings initiatives in the past must now revamp their programs.
CMS Star Quality Ratings: Shifting Strategies for Medicare Advantage and Part D Plans and Providers provides an in-depth look at the impact and implications of CMS’s star-ratings system so far, as well as how the star-rating program is likely to change in 2014, 2015 and subsequent years. The report includes:
- Specifics on the new measures under consideration, adopted and retired by CMS,
- Lessons learned from health plans that were stars winners and losers in the past,
- Strategies plans are using to improve their ratings amid a constantly changing landscape and political forces that could shape the program, and
- Details on how the star-ratings program affects marketing and enrollment.
Order CMS Star Quality Ratings: Shifting Strategies for Medicare Advantage and Part D Plans and Providers today and stay up to date with the ever-evolving world of Medicare star quality ratings.
Table of Contents
New measures under consideration, and those adopted and retired
- CMS may base more future star ratings on plan or parent rather than contract level
- CMS unveils potential star-rating changes, including way of calculating overall scores
- Access to, adherence with drugs tops CMS’s MA regulatory issues
- 2014 star-rating changes include use of individual-measure scores
Plans that are stars winners and losers
- MetroPlus applies multi-pronged approach to lift MA star ratings
- UPMC SNP’s initiatives, aided by providers, boost plan’s HEDIS scores
- Tufts touts benefits of linking initiatives in star-ratings efforts
- UCare finds that stars marketing is starting to boost understanding
- MA plans’ average star ratings rise for ’13; 15 get five stars, but weak spots remain
Stars’ impact on marketing and enrollment
- 2013 CMS marketing guidance changes disclaimers, website review, star ratings
- AEP marketing preview: More ‘preheating,’ star-ratings advertising are seen as likely
- CMS study finds higher MA star scores lift enrollment likelihood
Political issues with stars demo
- GAO blasts CMS stars bonus demo, but no moves are seen to end it
- Conservative group blasts CMS MA star ratings bonus program
- Stars demo woes: Issa subpoenas material, SNP contracts fare poorly in 2013 ratings
- Election results mean stars bonus demo is safe, but more MA pay cuts could come
Written By:
This book was written by the editorial staff of AIS, editors of Medicare Advantage News.
Written For:
- Health plan CEOs, CFOs, chief operating officers, government affairs and compliance directors, marketing executives, medical and clinical services managers, directors of provider relations, contracting executives, product directors, accountants and actuaries.
- Hospital and medical group CEOs, CFOs, administrators and directors of managed care contracting
- Pharmaceutical company and PBM executives
- Insurance agents, brokers and third-party administrators
- Health information technology company executives and marketing directors
- Attorneys, consultants and actuaries
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