CMS Unveils 5-Star Medicare Advantage Plans
The CMS star rating system is based on more than 40 quality measures, including preventive screenings, managing chronic conditions, and customer service.
Now the star rating system plays a strategic role in the development and growth of Medicare Advantage business.
During a recent conference call with stock analysts, Angela Braly, the president and CEO of WellPoint Inc., said the insurer's acquisition of CareMore, a Medicare Advantage plan, would "lead to higher quality star ratings that will be an increasingly important part of the Medicare program in the future."
During a similar call, Michael McCallister, Humana's chair of the board and CEO, said Humana "plans to reinvest heavily in improving our stars' processes, procedures and infrastructure to position us for further improvements in star metrics."
In addition to the dozen plans at the five-star level, another 97 achieved at least a four-star rating, which is the minimum number of stars needed to qualify for a bonus.
Unlike previous years when health plans were allowed to maintain their Medicare Advantage status despite poor quality ratings, CMS has proposed a rule that will give it the authority to terminate poor-performing Medicare Advantage and Part D sponsors that fail to achieve at least a three-star rating for three consecutive years.
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
- Healthcare Leaders Seek Strategic Sweet Spot
- 3 Reasons Wellness Programs Fail
- CMS Issues Health Insurance Exchange Proposed Rules
- Patients Shoulder Nearly 25% of Medical Bills
- ACOs Widespread, Yet Challenged
- MGMA: Physician Compensation Increasingly Based on Quality Measures
- 6 CNO-to-CEO Strategies
- HFMA: Patient Financial Interaction Guidelines Sharpened
- PwC: Pace of Rising Medical Costs Slowing
- Hacking Healthcare is Fred Trotter's Passion