Managed Healthcare Executive September 4, 2024
Denise Myshko

Changes to the methodology for how the Health Equity Index is assessed could see Medicare Advantage Star ratings — and payments to plans — drop.

Recent methodology changes to the Star rating system for Medicare Advantage and Part D plans will make it harder to maintain higher ratings, according to speakers during a session at the Pharmacy Benefit Management Institute’s National Conference.

The changes for 2025, which the Centers for Medicare and Medicaid Services (CMS) released in April 2024, impact the measures for the Health Equity Index (HEI) and risk adjustment and how these are weighted. CMS in its release said the aim of the change is “to advance health equity; drive comprehensive, person-centered care; and promote affordability and the...

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Topics: CMS, Equity/SDOH, Govt Agencies, Healthcare System, Insurance, Medicare Advantage
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