Medicare Stars Measures SY2024 (MY2022) - Virginia Premier Stay up to date on quality measures related to colorectal cancer screening and improve member outcomes. Star Rating System Overview - Cigna A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. While not deemed a Star measure, the HEI reward incentive structure would be geared to specifically address health disparities within care of an MA plans membership. WebCMS Star Ratings Calendar. For populations experiencing health disparities, additional barriers, such as reduced digital literacy, continue to worsen care gaps. Quality Measures On April 4 th, 2022, CMS released their 2023 Medicare Advantage and Part D Rate Announcement. While CMS agrees that these measures still play a crucial role in reflecting patient voice and experience of care, CMS wants to align the Stars program with their Quality Strategyfostering a healthcare system that promotes quality health outcomes, safety, equity, and accessibility. NCQA https://www.fticonsulting.com/insights/articles/star-ratings-whats-ahead. To advance health equity, CMS has put forward efforts in the Stars program through the Health Equity Index (HEI) incentive structure that rewards plans for specific measure-level scores for members with specific social risk factors (SRFs), such as receiving a low-income subsidy (LIS), being dually eligible, or having a disability. The Health Equity Index Reward. Puerto RicoThe proportion of Medicare beneficiaries who receive benefits through MA (as opposed to Medicare FFS) is far greater in Puerto Rico than in any other state or territory. 7: Star Ratings: Whats Ahead. Upcoming Changes to the Star Rating Program - Wakely During this time, Medicare beneficiaries can compare coverage options like Original Medicare and Medicare Advantage, and choose health and drug plans for 2022. The final 2024 Rate Announcement will be published no later than Monday, April 3, 2023. CMS Star In January 2021, the CMS Final Rule included the following measures in the 2024 Star Ratings calculation as 1x weight each: Transitions of Care and Follow-Up After Emergency Department Visit for People with High-Risk Multiple Chronic Conditions and brought back Plan All-Cause Readmissions as a Star measure14 (note: for 2025 Star Ratings MY 2023, CMS has indicated this measure weight will increase to 3x15). CMS chose to temporarily suspend the 60% rule. The CMS Star Ratings Medicare Advantage Plans are graded on a one to five Star Rating system by CMS. Healthcare Payer Resource Center | Cotiviti. CMS CMS calculated the rating with and without the improvement measure, applying the highest score. The National Committee for Quality Assurance (NCQA) is accepting comments through March 11 on proposed changes for HEDIS Measurement Year 2022 (MY 2022), which will be published in As NCQA continues to transition measures to the electronic clinical data systems (ECDS) reporting standards, Cotiviti offers four strategies that can help. As a result of those modifications, some higher cut points for these measures increased by four- or five-points last year. Looking ahead into next year, comments are due on the above details, among others, by February 13, 2023. Inflation Reduction Act of 2022 (IRA) Updates for 2024. Ilene MacDonald, Editorial Director | August 09, 2021. CMS proposed reclassifying the Statin Use in Persons with Diabetes (SUPD) measure from an intermediate outcome measure to a process measure, starting with the 2023 Star Ratings, due to feedback in response to the Draft 2020 Call Letter and to align with the measure stewards See how one plan increased their HRA completions by 2x+. Those most affected are near the cut lines. Transitions of Care now includes four indicators, and the Star measure will be an average of all four: Medication Reconciliation Post-Discharge, Notification of Inpatient Admission, Patient Engagement After Inpatient Discharge and Receipt of Discharge Information. The Centers for Medicare & Medicaid Services (CMS) on Wednesday released the 2024 Medicare Advantage (MA) proposed rule, which is scheduled to be published in the Federal Register on About QualityNet. The IRA made several amendments and additions to the standard Part D drug benefit defined in the Social Security Act. Federal government websites often end in .gov or .mil. Pay close attention to these quality measures during American Heart Month. The financial cost may be significant, especially for plans that experienced diminishing performance quality during the pandemic. CMS will carefully consider timely comments received before publishing the final Rate Announcement by April 3, 2023. The health equity index would create a single score summarizing contract performance across multiple social risk factor measures. Medicaid . 3420 Toringdon Way, Suite 330, Charlotte, NC 28277. CMS indicated that they expect the guardrail removal will have a negligible impact. 8: 4 Elements of a Successful Medication Adherence Strategy, RxAnte (Last visited January 21, 2023), https://www.rxante.com/health-plans/4-elements-of-a-successful-medication-adherence-strategy/. CMS designed the clause so plans with high star ratings wouldnt be penalized should low improvement measures lower their score. 2024 Categorical Adjustment Index Measure Supplement (PDF) 2023 Display Measures (ZIP) Tukey Outlier Deletion Simulations (ZIP) Cut Point Trends (ZIP) 2023 Medicare The proposed rule suggests the HEI reward structure begins for 2027 Star Ratings, leveraging data from measurement years 2024 and 2025. The extreme and uncontrollable circumstances policy for the 2022 Star Ratings noted that if a measure-level Star Rating was lower in the current year, the measure-level Star Rating would revert to the rating from the prior year. The Advance Notice contains detailed descriptions of these updates. When CMS first proposed the outlier deletion in 2020, it indicated that most outliers were on the low end of the spectrum. QBP uses the same measures as Star Ratings, and Medicare Advantage plans that achieve higher Star Ratings are eligible for additional funding through the QBP program. The agency will move the two measures to the display page on CMS.gov with a note that the comparisons are pre- and post-pandemic and that the measures are not being included in the 2022- and 2023-Star Ratings due to validity concerns related to the COVID-19 public health emergency. These policies include basing the MA county rates in Puerto Rico on the relatively higher costs of beneficiaries in FFS who have both Medicare Parts A and B and applying an adjustment. 3The underlying risk score trend is the average increase in risk scores, not accounting for normalization and MA coding adjustments, which are shown in separate rows. This notice contained several proposed changes to both methodology, calculation and future measures. Centers for Medicare & Medicaid Services. Viewed together, the proposals contained in the Contract Year 2024 Policy and Technical Changes could negatively impact Star Ratings even more for unprepared Medicare Advantage plans. Starting with the 2024 Star Ratings (2022 measurement period), CMS made it more difficult for plans to meet the performance standards necessary to retain or raise Star Ratings by removing performance outliers of non-CAHPS measures from the Tukey methodologys calculation of Star Rating cut points. With the refocus on member health outcomes, a good place to start is to ensure members receive annual wellness visits (AWVs) because theyve been proven to help drive other health actions, including breast cancer or colorectal screenings. Webbetter measure and strengthen methods of addressing health disparities; and driving value in the Medicare Advantage and Part D Star Ratings, the quality ratings system for Medicare Advantage of network areas for plan year 2024 is available on the CMS Network Requirements website. CMS Heres an overview: CMS will reduce the weighting of the Patient Experience/Complaints and Access to Care measures by half. Care transitions and post-acute follow up are paramount. Cut points are the ranges a health plans score on a particular measure needs to fall within to achieve each Star value. The Inventory lists each measure by program, reporting measure specifications including, but not limited to, numerator, denominator, exclusion criteria, Meaningful Measures included in the HEI, are strongly correlated with the included SRFs, or are Beginning in CY 2024, cost-sharing for Part D drugs will be eliminated for beneficiaries in the catastrophic phase of coverage. Included in the 2024 growth rate estimate is a proposed technical correction to the per capita cost calculations related to indirect and direct medical education costs associated with services furnished to MA enrollees; this correction results in a one-time adjustment to the growth rates. During CY 2024, Part D plans must not apply the deductible to an adult vaccine recommended by the Advisory Committee on Immunization Practices and must charge no cost-sharing at any point in the benefit for such vaccines. Beginning in CY 2024, the growth in the Base Beneficiary Premium will be capped at 6 percent. The agency may add new metrics or adjust the weightings of existing measurements to reflect the quality of care provided by a plan. Star Plans are rated on a one-to-five scale, with one The first reason for the increase in Star Ratings is the better of methodology. WebMelissa Smith discusses the 3 things Medicare Advantage plans should know and do based on CMS 2023 Final Rate Announcement. 2023 Medicare Advantage and Part D Star Ratings | CMS The proposed model includes important technical updates, including restructured condition categories using the. Measure . (November 3, 2022). Continued Focus on Member Satisfaction and Performance. 2024 Medicare Over the last several years, CMS has increased the Patients Experience and Member Complaints Star Rating measure weights from 1.5 to 4, reinforcing the focus on and commitment to We are excited to offer an opportunity to learn about quality measures. FTI Consulting. The measures rely on models to predict expected changes in physical and mental health status and mortality from baseline to follow-up, based on relative contract performance. The table below lists all possible measures that could be included. Medicare Advantage (MA) health plan members are at their most vulnerable during transitions of care.
For Sale By Owner Rutherfordton, Nc,
1205 Broadway, Burlingame Ca 94010,
Articles C
cms star measures 2024
