Every year, the Centers for Medicare & Medicaid Services (CMS) publishes Star Ratings to measure the quality of health and drug services received by Medicare members. To rate Medicare Advantage plans, CMS uses:
- Health Effectiveness Data and Information Set (HEDIS®′) scores
- Results from patient experience and health outcomes surveys
- Data provided by the plans and their network providers
The Find Health & Drug Plans tool at Medicare.gov includes Star ratings for each plan to help consumers search and compare quality. (CMS also has a Five-Star Quality Rating System for nursing homes.)
Resources
- New!
Medicare Advantage 5-Star Provider Playbook
This guide contains actionable, evidence-based information, tips, and best practices to help you coordinate your patient’s care and improve health outcomes. Contents include:- Star measures and who the measures affect
- CPT code suggestions to use as applicable
- Recommended best practices to close gaps in care
- Details on the patient experience surveys that CMS conducts annually with Medicare beneficiaries and recommended best practices to improve performance.
- Experience and Outcomes Surveys
- HEDIS
