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

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.

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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