Each year the Centers for Medicare and Medicaid Services (CMS) rates all Medicare Advantage (Part C) plans and Medicare Prescription Drug Plans (Part D). Ratings are assigned based on a scale from 1 star to 5 stars:
There are currently three dozen measures in five categories which contribute to Medicare Advantage star ratings. Rating factors come from a number of sources such as member surveys, data from physicians, monitoring from CMS, and self-reported information from the plan’s carrier. The following table provides information on factors that determine the overall health plan quality rating for Medicare Advantage plans:
|Screenings, Tests & Vaccines||Whether plan members received an annual flu shot, screening tests such as glaucoma testing, colonoscopies, and mammograms, and other check-ups to help them remain healthy such as cholesterol tests and checking if members are at a healthy weight|
|Managing Chronic (Long-Term) Conditions||How often members with various chronic conditions receive tests and treatments that help them manage their long-term condition. This measure also includes information on hospital readmissions. Examples of chronic health conditions include:|
|Plan Responsiveness & Care||Ratings from members on:|
|Member Complaints, Issues Getting Services, and Performance Improvement|
|Plan’s Telephone Customer Service|
Star ratings are not currently available for 2015 Medicare Advantage plans but they will be released in late September or early October 2014 and will be available to view through our Medicare plan comparison tool. Check this page again in October for additional information and analysis of 2015 Medicare Advantage plans. Visit our Medicare Part D Star Ratings page for information on 2015 CMS star ratings for Medicare prescription drug plans.
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