MedCity News July 18, 2024
Dr. Liz Kwo

SMS is reevaluating its Star Ratings. Not only do health plans stand to benefit from the new calculations — all healthcare companies and millions of patients will reap the rewards.

Centers for Medicare and Medicaid Service (CMS)’s decision to recalculate its quality ratings for private Medicare Advantage health plans is making headlines, as first reported by The Wall Street Journal. The higher the CMS Star Rating (one to five stars), the higher the health plan scores on CMS quality measures, which results in bonus payments from the agency.

CMS Star Ratings have been the gold standard for payers for nearly two decades — so, what is causing the agency to reevaluate its quality ratings? CMS implemented a new statistical process...

Today's Sponsors

LEK
ZeOmega

Today's Sponsor

LEK

Continue Reading

 
Topics: CMS, Govt Agencies, Insurance, Medicare Advantage, Patient / Consumer, Provider
Related Articles:
In the face of rising MA plan denials, health systems must engage in strategic, aggressive escalation
Use of Prior Authorization Up in Medicare Advantage Plans, Senate Report Finds
Podcast: Medicare Advantage Star Ratings Continue to Fade but Market Marches On Into 2025
Election Lead-Up: Marketplace and Medicare Advantage Head-to-Head
STAT+: Medicare Advantage insurers ramped up use of technology to deny claims, Senate investigation shows

Share This Article