cms stars measures 2023cms stars measures 2023

2023 Medicare Advantage and Part D Star Ratings Fact Sheet, With roughly 70% of Medicare members and 81% of Medicaid members completing an AWV before completing any other high-value activity. Replicating best practices of any specific competitor is no longer feasible for the new needs of Stars. The first year is the measurement period in which plans generate performance data for most measures, though timing varies by component (for example, Consumer Assessment of Healthcare Providers and Systems, or CAHPS, surveys are fielded at the beginning of the second year). For PDPs, the relationship is similar in that PDPs with 10 or more years in the program do better in the Star Ratings relative to contracts with less experience. Star ratings in 2022 were also affected by the increased relative weight of member experience measures. Healthmine loves helping plans achieve and sustain strong ratings. The overall rating is the weighted average of a plan's HEDIS and CAHPS measure ratings, plus bonus points for plans with a current Accreditation status as of June 30, 2023. Third, CMS will remove performance outliers from the calculation of non-CAHPS measure rating cut points in rating year 20247Contract year 2021 Medicare Advantage and part D final rule (CMS-4190-F1) fact sheet, CMS, May 22, 2020. using the Tukey outlier deletion method.8Tukey outlier deletion is a statistical method for identifying and removing outliers based on the interquartile range of the set. According to Hartnett, the ADI is a collection of data points created by the Health Resources and Services Administration to rank neighborhoods by socioeconomic . Section 3014 of the Patient Protection and Affordable Care Act establishes the CMS Pre-Rulemaking process for the selection of measures for adoption in U.S. Department of Health & Human Services programs. The measures in Tables 1-3 are shown in order of which have the largest increases to the largest decreases in scores from the 2021 to 2022 Star Ratings. For more information on the 2023 Medicare Advantage and Part D Star Ratings, including a fact sheet, please visit: http://go.cms.gov/partcanddstarratings. In the longer term, MA plans will no longer need to guess which measures will have significant fluctuations in cut points, because those fluctuations will be constrained by new guardrails beginning in rating year 2023. Sign up to get the latest information about your choice of CMS topics in your inbox. In rating year 2023, when this better of methodology no longer applies universally, average contract Star ratings may revert from the average of 4.37 across all contracts in rating year 2022 to 4.074.17, their levels during rating years 201921, before the methodology was expanded to accommodate the pandemic. For MA-PDs, approximately 72% of the non-profit contracts received 4 or more stars compared to 43% of the for-profit MA-PDs. _4Mc:y?8yxMyM_a6YMOiv^)si|J7'o|L7:m86k:hcx%3"/v9]$/lo1r|!o;Wr*8:;8;88888888%kbaVfYaVfYaA9SLvtvt-yfGAGaGAGaGAGeGEGMpS)n While our results do not predict future trends in raw-measure performance, they illustrate that changes to the methodology for translating raw performance into Star ratings may create financial challenges for health plans in future years. Data from the 2019 through 2021 measurement periods help us understand how the PHE impacted the care delivery system. For many plans, particularly those that have yet to regain footing in their quality programs during the pandemic, the financial impact will be substantial. See also the CY 2022 Rate Announcement at Announcement of Calendar Year (CY) 2022 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (cms.gov) (explaining how the change in the collection of HEDIS data in 2020 resulted in this measure being on the display page for the 2021 and 2022 Star Ratings to comply with 422.164(d)(2)). The 2023 version of the star rating system measures the value a plan is delivering to its . Sonja Pedersen-Green is an associate partner in McKinseys Minneapolis office, and Cara Repasky is a partner in the Pittsburgh office. As the Department of Health and Human Services and other federal agencies prepare for the potential that more than 60% of Medicare beneficiaries will be enrolled in Medicare Advantage (MA) plans by 2032, and for partial Medicare Hospital Trust Fund insolvency (which covers Part A) by 2028, it will be both vital and inevitable to add more measures to chase the cost reduction component of the Triple Aim. June 29, 2023. Not all measures would have been affected by the outlier removal and guardrails. The last column of these tables highlights more substantive changes of 2 percentage points or more in either direction. The airline was also hit by COVID-related flight cancellations and drastic headcount reductions owing to quarantine . Specifically, plans can consider three types of actions: The next several years may be difficult for MA plans as CMS shifts to a more demanding Star rating methodology that will require contracts to perform better to maintain current ratings. Plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance. Table 5: 2020 - 2023 Part D Rating Distribution for PDPs. Healthcare Payer Resource Center | Cotiviti. For MY 2023, HEDIS added five new measures, retired five measures, substantially changed a measure and made small changes across multiple measures. Thirty percent of weighted CAHPS measures received equivalent measure scores and ratings in rating years 2021 and 2022, a sign that plans may have used historical rather than current-measure performance. Medicare Advantage Star ratings rose to all-time highs in 2022, What Medicare Advantage members want from their onboarding experience, From facility to home: How healthcare could shift by 2025, What the future holds for Medicare beneficiaries. Contrary to the decreased performance and cutpoints on HEDIS and CAHPS measures, Part D cutpoints continued to rise despite no change in the national average performance. 422.166(i), 423.186(i)). 2023 Star Ratings: What to Know and What to Do Now, sound the alarm bell loudly and immediately to leadership, decreased dramatically and pervasively this year, 60% of Medicare beneficiaries will be enrolled in Medicare Advantage (MA) plans by 2032, CMS $4.1 billion in quality bonus payments by 2030, Risk Adjustment 101: What Medicare Advantage Plans Need to Know, Identifying Opportunities for Improvements With Health Outcome Surveys, Star Ratings and The Risk of Being Too Tactical, Guide Member Health Journeys With Digital Health Apps, Build an Effective Business Case for Additional Stars Resources. Tables 1-3 below include information at the national level about the overall change in contract-level average measure scores (i.e., unweighted by the size of the contract) from the 2021 to 2023 Star Ratings (for all measures without a substantive specification change across the three years). In our retroactive analysis, the contracts most affected by cut point changes were those that received 3.5- and 4.0-Star ratings in rating year 2020; 23 percent of these contracts (enrolling 14 percent of beneficiaries) would have had been rated 0.5 Stars lower (Exhibit 4). Additionally, starting in 2023 under the Inflation Reduction Act, people with Medicare prescription drug coverage will have improved and more affordable benefits, including a $35 cost-sharing limit on a months supply of each covered insulin product, as well as adult vaccines that are recommended by the Advisory Committee on Immunization Practices (ACIP) at no additional cost. : the enrollment-weighted average contract rating rose to 4.37 Stars, an all-time high in the programs 12-year history.2Fact sheet - 2022 Part C and D Star ratings, CMS, October 8, 2021. Highlights of Contract Performance in 2023 Star Ratings[1], Changes in the Methodology for the 2023 Star Ratings, Medicare Advantage with prescription drug (Part D) coverage (MA-PD) contracts are rated on up to 38 unique quality and performance measures; MA-only contracts (without prescription drug coverage, or Part D) are rated on up to 28 measures; and stand-alone Part D (PDP) contracts are rated on up to 12 measures. hbbd```b``z "sA$2D27eHvfs$+_E`Z 7AdH%y; F This session will include: Detailed review of upcoming technical changes, new 2024 measures and key MA program changes impacting Star Ratings Quality relies on the orchestration of a host of factors. 820 0 obj <> endobj Section 3014 of the Patient Protection and Affordable Care Act establishes the CMS Pre-Rulemaking process for the selection of measures for adoption in U.S. Department of Health & Human Services programs. For 2023, UnitedHealthcare - H3113 received the following Star Ratings from Medicare: Overall Star Rating: 4 stars Health Services Rating: 4 stars Drug Services Rating: 4 stars Every year, Medicare evaluates plans based on a 5-star rating system. Its inevitable that CMS is going to add health equity to Stars imminently, numerous new measures can still be added for MY2023, and theres only another 16 months before the challenging 3x-weight Health Outcomes Survey measures return to Stars. Due to the suspension of data reporting during the COVID-19 pandemic, an increased weight on CAHPS, and the security of performing well historically in cancer screening HEDIS measures, many plans took these measures for granted. Hong Kong's flagship carrier parked much of its fleet during the pandemic due . With these changes, NCQA also continued the transition to Electronic Clinical Data Systems (ECDS) reporting. Contracts used better of performance most frequently for CAHPS measures, a category that has been gradually increasing in weighting since 202011New Stars ratings, October 15, 2020. and will reach its target weight in 2023. %PDF-1.6 % Compounding the expected return to more normal measure rates in MY2022 and MY2023, we are now two-thirds of the way through the first measurement period for which CMS will apply the Tukey Outlier deletion model to cutpoints. The scores are shown prior to any adjustments under the extreme and uncontrollable circumstances rules; thus, they reflect actual performance during the measurement period. 2022 DQA on behalf of ADA, all rights reserved. ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. Highmark Western and Northeastern New York Inc. MARTIN'S POINT GENERATIONS ADVANTAGE, INC. CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA, University of Wisconsin Hospitals and Clinics Authority, Table A2: 1876 Cost Contracts Receiving the 2023 High Performing Icon*, Table A3: PDP Contracts Receiving the 2023 High Performing Icon. CMS Star Ratings data (2013 to 2022) and September enrollment data (2013 to 2021). Osteoporosis is responsible for an estimated two million broken bones per year, yet nearly 80% of o. Our analysis suggests that deteriorating CAHPS performance could have a significant impact on MA plans overall Stars performance. A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. The average Star Rating is weighted by enrollment. An analysis of CMS 2023 Medicare Advantage and Part D Star Ratings Fact Sheet shows that the national average measure score for breast cancer screening was down 0.74 compared to 2022 and down 4.3 compared to 2021. Note that enrollment weighted Star ratings may differ slightly from CMS reports due to enrollment data used in analysis. 2022 and 2023 Star Ratings . Medicare Advantage Star ratings may decline with new methodology. * The average Star Rating is weighted by enrollment. Catherine Howden, DirectorMedia Inquiries Form People who want to keep their current Medicare coverage do not need to re-enroll. The Centers for Medicare & Medicaid Services (CMS) publishes the Medicare Advantage (Medicare Part C) and Medicare Part D Star Ratings each year to measure the quality of health and drug services received by consumers enrolled in Medicare Advantage (MA) and Prescription Drug Plans (PDPs or Part D plans). The Centers for Medicare & Medicaid Services (CMS) Measures Under Consideration (MUC) Entry/Review Information Tool is now open for 2023 quality and efficiency measure submissions! There is still time to salvage MY2022 performance to prevent the second year of the 2.5-star rating, but the math is extremely detailed and complicated to ensure the summary ratings are captured in the work. Studies show that breast cancer is the most costly cancer to treat, followed by colorectal cancer, which indicates that plans cant afford to take their eye off the ball where cancer screenings are concerned. The new Tukey outlier removal methodology will mean that poorly performing plans will no longer bolster the ratings of other plans. This cycle creates a two-year lag between the performance and rating period. Executive Vice President of Consulting & Professional Services. All Star Ratings referenced in Tables 10, 11, and 12 are after the adjustments to address concerns about collecting CAHPS and HEDIS data for the 2021 Star Ratings, regulatory adjustments for extreme and uncontrollable circumstances triggered by the COVID-19 PHE for the 2023 Star Ratings (for non-HOS measures), and the regulatory disaster adjustments for extreme and uncontrollable circumstances triggered by the COVID-19 PHE for HOS measures, and other qualifying extreme and uncontrollable circumstances,[9] for the 2021 performance period have been applied. Both systems allow plans to add points to their overall score. Similarly, for PDPs approximately 42% of non-profit PDPs received 4 or more stars compared to 25% of the for-profit PDPs. **For Complaints about the Plan and Members Choosing to Leave the Plan a lower score is better. A 2019 report by the Kaiser Family Foundation found that the gross margin for Medicare Advantage plans was $1,608 per covered person. By eliminating performance outliers from the calculation of Star rating cut points using the Tukey methodology beginning in rating year 2024, CMS will make it more challenging for plans to achieve the performance required to maintain or improve Star ratings. 2023 Healthmine, Inc. All rights reserved. Recheck your Improvement measure calculation to ensure that the right measures were excluded based on use of the EUC policy. Table 3: Changes in Part D Measure Scores from 2021 to 2023 Star Ratings for PDP Contracts. H\j@}l/BB.(s?f`D[Sn}fScw9 :bP,jyK;e MA-PDs with 10 or more years in the program are more likely to have 4 or more stars compared to contracts with fewer than five years in the program. or For MY 2023, HEDIS added five new measures, retired five measures, substantially changed a measure and made small changes across multiple measures. Note that enrollment-weighted Star ratings may differ slightly from CMS reports due to enrollment data used in analysis. The introduction of the Tukey outlier removal methodology will take effect for rating year 2024 based on 2022 performance data. Every day and week matters to make sure your plan gets or stays on a strong trajectory. The 2024 star ratings (2022 DOS) are expected to consist of 38 measures across the following five domains: Star measure weights and cut-points Star measures are categorized into the following three measures and weighted accordingly: means youve safely connected to the .gov website. Tip: If any one of your contracts received an overall rating, a Part C summary rating, or a Part D summary rating under 3 stars, sound the alarm bell loudly and immediately to leadership. Optimize Medicare Advantage Star Ratings with Star Intelligence Read the fact sheet 2022 Star Ratings changes due to COVID-19 To account for changes in care brought on by the COVID-19 pandemic, CMS implemented several changes for Star Ratings 2022, including: With the significant changes in healthcare and clinical care patterns in 2022, there is no reason to thinks that Measurement Year (MY) 2021 historical experiences are as useful as benchmarks for MY2022 expected performance without making adjustments to account for post-COVID return to reality. Copyright 2023 National Committee for Quality Assurance. Take a look at this calendar as a reminder of proposed and confirmed upcoming changes to the CMS Star Ratings system for 2024 and beyond. Men in the United States are least likely to rate their healthcare experience positively. In response to the COVID-19 pandemic, CMS allowed all contracts to use the existing disaster provision for rating year 2022, causing Star ratings to be calculated based on the better of current or historical performance for most measures.9Fact sheet, October 8, 2021. CMS is adopting substantive changes to the Improving or Maintaining Physical Health and Improving or . RESOURCES FOR HEALTH PLANS NCQA's Health Plan Ratings 2023 include commercial, Medicare and Medicaid health plans. * Measures from CAHPS used data from the 2020 Star Ratings (collected in 2019 and unaffected by the COVID-19 PHE). We also see a significant easing of 2- and 3-star cutpoints, with less easing among high performers who drove more success on 4- and 5-star cutpoints. One way plans can refocus on preventive screenings is by utilizing Annual Wellness Visits (AWVs). We do not share your information with third parties. Intent: Good oral health is a vital component of a childs overall health, and oral examinations are important to prevent disease, reverse disease processes, prevent progression of caries and reduce incidence of future lesions. . 2023 saw a return to more normal evaluations overall and a return to earth for MA-PD plans. CMS Star Ratings data (2013 to 2022) and September enrollment data (2013 to 2021). 422.166(h)(1)(ii), 423.186(h)(1)(ii). Many plans are still working too hard trying to keep up with other health plans. Members who call your call center, who are new to your plan, and who have experienced (or will experience) a change in their benefits are your most likely candidates for dissatisfaction. Medicare Advantage with prescription drug (Part D) coverage (MA-PD) contracts are rated on up to 38 unique quality and performance measures; MA-only contracts (without prescription drug coverage, or Part D) are rated on up to 28 measures; and stand-alone Part D (PDP) contracts are rated on up to 12 measures. This equates to more than one full star drop on the Part C measure, and a full 1.5 star drop on the Part D measure. Even in the absence of an off-cycle survey response, being attentive to members who are most likely to be dissatisfied can ensure you identify irritations before they manifest as poor CAHPS survey scores. Average contract ratings began to stabilize after rating year 2016 as quality-improvement programs became necessary elements of a competitive MA offering. endstream endobj 826 0 obj <>stream Tukey outlier deletion is a statistical method for identifying and removing outliers based on the interquartile range of the set. CMS News and Media Group Table 1: Changes in Part C Measure Scores from 2021 to 2023 Star Ratings for MA Contracts, Increase / Decrease in Performance from 2022 to 2023, Statin Therapy for Patients with Cardiovascular Disease*, Medication Reconciliation Post-Discharge*, Plan Makes Timely Decisions about Appeals, Diabetes Care Kidney Disease Monitoring*, Call Center Foreign Language Interpreter and TTY Availability, Care for Older Adults Medication Review*, Osteoporosis Management in Women who had a Fracture*. As a result of these methodology changes, the weighted average Star rating for all contracts increased from 4.08 in rating year 2021 to 4.37 in 2022, and 90 percent of enrollees were enrolled in contracts with 4.0 Stars or higher in 2022, representing record highs.2CMS Star Ratings data (2013 to 2022) and September enrollment data (2013 to 2021). To order publications, call 888-275-7585 or visit the NCQA Publications website. Data points that are more than 150 percent of the interquartile range above the third quartile are identified as outliers and removed, as are points less than 150 percent of the interquartile range below the first quartile. Second Plan Preview is underway and has kicked off a flurry of energy and enthusiasm in pursuit of quality excellence in Medicare Advantage. This is particularly noteworthy since there was only one measure added in 2021, so the performance struggle reflects real struggles in long-known, long-established measurement areas. For example, leading plans have delivered quality-focused training to front-office staff, deployed interactive text messaging, and used predictive analytics to launch call campaigns focused on medication adherence. The scores are shown prior to any adjustments under the extreme and uncontrollable circumstances rules; thus, they reflect actual performance during the measurement period. It was updated to account for members achieving 100% discontinuation without intermediate taper in the measure numerator. [2] See CY 2020 and 2021 final rule (CMS-4185-F) at Federal Register :: Medicare and Medicaid Programs; Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Programs of All-Inclusive Care for the Elderly (PACE), Medicaid Fee-For-Service, and Medicaid Managed Care Programs for Years 2020 and 2021. For example, plans that are struggling with elevated complaint volumes could analyze the root causes of those complaints and launch targeted initiatives such as member outreach campaigns to avert poor member experiences before they occur. AWVs provide early detection of chronic disease and the opportunity to discuss advanced care planning, including breast cancer or colorectal screenings. Our analysis suggests that more contracts will have increased ratings than decreased ratings as a result of weight shifts. The good news for MA plans is that there is still time to act before the measurement period for rating year 2024 closes in December 2022. During this time, Medicare beneficiaries can compare coverage options, including Original Medicare and Medicare Advantage, and choose high quality health and drug plans for 2023. Plan leaders love to believe that cutpoints are predictable, and that prior year cutpoints alone are a reliable predictor of the future. The Centers for Medicare & Medicaid Services (CMS) released the 2023 Star Ratings for Medicare Advantage (Medicare Part C) and Medicare Part D prescription drug plans to help people with Medicare compare plans ahead of Medicare Open Enrollment, which kicks off on October 15. Hong Kong's flagship carrier parked much of its fleet during the pandemic due to a lack of demand. This calendar summarizes proposed and confirmed upcoming changes to the CMS Star Ratings system for 2024 and beyond to help you stay ahead of measure and policy changes on the horizon. 4/24/2023. Taking a member-centric approach is key to closing gaps in care, ensuring member satisfaction, addressing social needs screening and interventions (SNS-E), improving medication adherence, and driving the completion of health risk assessments. However, the short-term impact overall is minimal in 2022 and 2023. The newest additions to HEDIS address pediatric dental care, safety and appropriateness, diabetic care and social needs screenings and interventions. For a subset of members 67 and older with diabetes (types 1 and 2) who had at least one dispensing event of insulin within each 6-month treatment period from July 1 of the year prior to the measurement year through December 31 of the measurement year, the risk-adjusted ratio of O/E ED visits for hypoglycemia, stratified by dual eligibility. The Centers for Medicare & Medicaid Services (CMS) released the 2023 Star Ratings for Medicare Advantage (Medicare Part C) and Medicare Part D prescription drug plans to help people with Medicare compare plans ahead of Medicare Open Enrollment, which kicks off on October 15. The 2022 Overall Star Rating selects 47 of the more than 100 measures CMS publicly reports on Care Compare and divides them into 5 measure groups: Mortality, Safety of Care, Readmission, Patient Experience, and Timely & Effective Care. 7500 Security Boulevard, Baltimore, MD 21244, An official website of the United States government, Prescription Drug Coverage - General Information, Part D Information for Pharmaceutical Manufacturers, Pharmaceutical Manufacturer Patient Assistance Program Information, Stratified reporting documentation - 2022-2023 Star Ratings (PDF), 2024 Categorical Adjustment Index Measure Supplement (PDF), 2023 Medicare Star Ratings Fact Sheet (PDF), 2023 Categorical Adjustment Index Measure Supplement (PDF), 2022 Star Ratings Fact Sheet_10_8_2021 (PDF), 2022 Star Ratings Technical Notes (Oct 4 2022) (PDF), 2022 Star Ratings Data Table (Oct 06 2021) (ZIP), 2022 Categorical Adjustment Index Measure Supplement (PDF), 2021_Star_Ratings_Fact_Sheet 10 13 2020 (PDF), 2021 Star Ratings Data Table (Oct 08 2020) (ZIP), 2021 CAI Measure Selection Supplement (PDF), Star Ratings Technical Notes (Oct 10 2019) (PDF), 2020 Star Ratings Data Table (Oct 21 2019) (ZIP), 2020 CAI Measure Selection Supplement (PDF), 2019 Part C and D Medicare Star Ratings Data (v04 12 2019) (ZIP), Industry-wide Appeals Timeliness Monitoring Memo (November 28, 2016) (PDF), Industry-wide Timeliness Monitoring (PDF), 2018 Star Ratings and Display Measures (ZIP), 2017_Star_Ratings_and_Display_Measures (ZIP), 2016_Star_Ratings_and_Display_Measures (ZIP), 2015_Star_Ratings_and_Display_Measures (ZIP), 2014_Star_Ratings_and_Display_Measures (ZIP), 2013_Plan_Ratings_and_Display_Measures (ZIP), 2012_Plan_Ratings_and_Display_Measures (ZIP), 2011_Plan_Ratings_and_Display_Measures (ZIP), 2010_Plan_Ratings_and_Display_Measures (ZIP), 2014 RFI Submissions (02252015) v2a (ZIP), Historical Categorical Adjustment Index Documents (ZIP). Starting with the 2023 Star Ratings, the Rheumatoid Arthritis Management (Part C) measure was retired and the updated Statin Use in Persons with Diabetes (Part D) measure weighting category was implemented (changed from an intermediate outcome measure with a weight of 3 to a process measure with a weight of 1). As finalized in previous rulemaking, the updated Controlling Blood Pressure (Part C) measure was re-specified and was transitioned off the display page and into the 2023 Star Ratings as a new measure. September 15, 2022 | Article (9 pages) The Centers for Medicare & Medicaid Services (CMS) uses a Star rating system to measure the performance of Medicare Advantage (MA) plans. Member engagement and member satisfaction are year-round endeavors. 2023 saw a return to more normal evaluations overall and a return to earth for MA-PD plans. Last year, no contracts received this warning. In addition, member engagement and educationensuring members are educated about, utilizing, and even rewarded for taking advantage of their benefitscan break the cycle of member attrition. Democrat McKee included $592,405 in his proposed 2023-24 budget to provide abortion coverage for an estimated 80,000 women of child-bearing age enrolled in Medicaid and another $29,500 to add . Maintaining a Star rating of four or higher can help plans remain financially stable, offer rich supplemental benefits for members, and compete for the 56 percent of enrollees14Marina Ivanenko, Dan Jamieson, and Cara Repasky, What Medicare Advantage members want from their onboarding experience, McKinsey, April 18, 2022. for whom Star ratings are a top buying factor. 202-690-6145. For example, a contract that registered 0.32 complaints per 1,000 members earned a 5-Star rating on this measure in 2020, but it would have earned a 3-Star rating under the new cut point methodology. Stars Measure Changes . An official website of the United States government. Approximately 51% of MA-PDs (260 contracts) that will be offered in 2023 earned 4 stars or higher for their 2023 overall rating. Proposed changes could potentially have to go through the rule making process and . Executives need to understand, support and resource all of these things alongside this years fourth quarter push. What You Need to Know About CMS' Recent Flurry of MA Star Ratings Reports, Data and Notifications. https:// New CMS Star Ratings were released on October 6 and offered a few surprises. For the first time since the inception of Star Ratings, actual quality performance decreased dramatically and pervasively this year. CMS will begin denying new contract applications and applications for service area expansions for any parent organization that has any contract with any overall or summary ratings for two or more years beginning in 2023. This provision was used for an estimated 21 percent of measure ratings nationally (Exhibit 1). Improvement in CMS Star Ratings isnt about any one thing. There is no time to wait if you own one of these contracts and have any desire to expand in plan year 2024! The Centers for Medicare & Medicaid Services (CMS) publishes the Medicare Advantage (Medicare Part C) and Medicare Part D Star Ratings each year to measure the quality of health and drug services received by consumers enrolled in Medicare Advantage (MA) and Prescription Drug Plans (PDPs or Part D plans). There is one contract identified on the Medicare Plan Finder with a low performing icon[8] for 2023 for consistently low quality ratings. If you need help to ensure your success in 2022, call us. FACT SHEET October 6, 2022 Contact: CMS Media Relations (202) 690-6145 | CMS Media Inquiries 2023 Medicare Advantage and Part D Star Ratings Note: The information included in this Fact Sheet is based on the 2023 Star Ratings published on the Medicare Plan Finder on October 6, 2022. The CMS Star Ratings Medicare Advantage Plans are graded on a one to five Star Rating system by CMS. Additionally, 51% of plans that will be offered in 2023 earned 4 Stars or higher for their 2023 overall rating, compared to 68% of plans in 2022 earning 4 Stars or higher. The Pre-Rulemaking process helps to support CMSs goals to fill critical gaps in quality measurement and consider multi-stakeholder input on measure selection.