Medicare Advantage Demo to Use Financial Incentives to Boost Quality
The Centers for Medicare & Medicaid Services said it will update its five-star plan ratings in 2011, and use the new metric as the basis for quality bonus payments in a three-year demonstration project for Medicare Advantage health plans that starts in 2012.
The five-star rating system is used by CMS to ensure that health plans meet Medicare quality standards. The ratings allow beneficiaries to compare the quality of care and customer service that Medicare health and drug plans offer.
In addition, a "low performer" icon will be placed next to plans with fewer than three stars for the past three years. CMS' star rating system considers 53 quality measures, including preventive services, managing chronic illness, and keeping consumer complaints to a minimum. All ratings can be found on Medicare's Plan Finder.
The 2011 ratings released Friday will serve as the basis for a quality bonus payment in the demonstration for Medicare Advantage plans beginning in January 2012. The demonstration builds on the quality bonus payments authorized in the Affordable Care Act by providing stronger incentives for plans to improve their performance and accelerate quality improvements. Medicare Advantage plans earning the highest performance rating—five stars—can get bonuses equal to 5%, and all plans with three stars or more will qualify for a bonus payment beginning in 2012.
- CMS Sets 2014 Pay Rates for Hospital Outpatient and Physician Services
- FDA hopes hospitals will switch to newly regulated pharmacies
- Not-for-Profit Hospitals Find Opportunity Amid Uncertainty
- New G-Codes to Pay Doctors for Broad Array of Non-Face-to-Face Care
- The Most Polarizing Topics in Healthcare IT
- The 5 Biggest Healthcare Finance Trouble Spots
- Why You Should Involve Patients in Nursing Handoffs
- States Rejecting Medicaid Expansion Forgo Billions in Federal Funds
- How CPOE Will Make Healthcare Smarter
- Safety Net Executives Renew Call to Preserve DSH Payments