Medicare Advantage

New Star Rating cutoffs for 2017 are out. As expected, the new cutoffs deviated from last year’s cutoffs, and will substantially affect the calculation of the overall Star Rating. Once again, many MA plans will be surprised.

In this article, we estimate the dollar impact of improving one star rating measure in the MA Star Rating system. Based on the CMS advance notice [1], if an MA plan scores 4 stars and above, the plan can receive 5% Quality Bonus Payments (QBP). Below 3.5 stars, plans…

Each year, the Centers for Medicare and Medicaid Services (CMS) collect various quality and performance measures on Medicare Advantage (MA) plans. CMS analyzes this massive collection of information and assigns from 1 star to 5 stars to each…