CMS Star Quality Ratings: Shifting Strategies for Medicare Advantage and Part D Plans and Providers

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Publication Details

  • Publication Date: 2012
  • Pub Code: BCSQ-11WEB
  • Pages: 34
  • PDF version: 430KB
  • ISBN: 978-1-936230-25-9

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CMS Star Quality Ratings: Shifting Strategies for Medicare Advantage and Part D Plans and Providers

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 the future. Includes details on CMS’s changes to the weights and measures used in determining star ratings, lessons learned from health plans that were stars winners and losers for 2012, and strategies plans are using to improve their ratings amid a constantly changing landscape.

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From the editors of Medicare Advantage News

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 2012 and subsequent years. The report includes:

  • Details on the new measures under consideration, adopted and retired by CMS,
  • Lessons learned from health plans that were stars winners and losers for 2012,
  • Strategies plans are using to improve their ratings amid a constantly changing landscape, and
  • Perspectives on the financial aspects of quality bonuses.

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 Will Stress Outcome Measures in New Star Ratings, Won’t Adjust for Region
  • CMS Is Seen Giving Higher Star Weights to Clinical Items in Wake of Plan Comments
  • CMS Unveils Specific Star-Rating Measures to Add, ‘Retire’; Changes May Cut Scores
  • Updated CMS Star-Rating Changes Delay Some Shifts, but Not Most
  • CMS Proposes ‘Benign’ MA/Part D Rule, Letting It Cut Plans, Delve Into Contracts
  • CMS Unveils Planned 2013 Star-Rating Changes, Including Improvement Measure

Plans That Are Stars Winners and Losers

  • Far More MA Plans Get Top Star Ratings for 2012; Six Kaiser Units Get Five Stars
  • Stars Winners Include Humana, United; Universal American Loses
  • Essence Cites Star Ratings, Luring Medigap Enrollees for AEP Gains

Strategies for Boosting Star Ratings

  • MA Plans Looking to Boost Star Ratings Form Burgeoning Market for Data Vendors
  • MA Plans Look to OTC Benefits to Boost Enrollment, Star Ratings
  • Drug Measures Hurt Star Ratings for MA Plans, Require Closer Ties

Financial Aspects of Star-Rating Bonuses

  • Quality Bonus Will Aid Plans Mainly Through Rebates, Not Big Payments
  • CMS Lowers 2012 Pay Rates in Final Notice, but Proceeds With Extending Quality Bonus
  • CMS Escalates Its Use of Letters Seeking CAPs From MA Plans With Low Star Ratings

Written By

This book was written by the editorial staff of AIS.

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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CMS Star Quality Ratings: Shifting Strategies for Medicare Advantage and Part D Plans and Providers

Place your order through our secure shopping cart

$84.00
$84.00