Star Ratings Program
The Centers for Medicaid and Medicare (CMS) established the Star Ratings Program to measure and help improve the quality of care provided to Medicare Advantage beneficiaries.
The Star Ratings Program focuses on three areas:
- Clinical quality of care provided
- Patient perception of health and healthcare received
- Health Plan operations
Health plans are rated on a scale of 1-5 Stars based on their score across these quality measures.
MEASURE SPECIFICATIONS
STAYING HEALTHY
- Breast Cancer Screening
- Colorectal Cancer Screening
- Adult BMI Assessment
- Improving or Maintaining Physical Health
- Improving or Maintaining Mental Health
- Physical Activity in Older Adults
- Fall Risk Management
DIABETES
- Diabetes Care - Retinal Eye Exam Performed
- Diabetes Care - Medical Attention for Nephropathy
- Diabetes Care - Blood Sugar Control
HYPERTENSION
MEDICATION MANAGEMENT
- Medication Adherence for Diabetes Medications
- Medication Adherence for Hypertension (RAS antagonists)
- Medication Adherence for Statins
- Medication Therapy Management - CMR Completion
- High Risk Medication in the Elderly
- Rheumatoid Arthritis
- High Risk Medication and Formulary Alternatives
CARE TRANSITIONS
BONE HEALTH
CARE OF OLDER ADULTS
- SNP Care Management
- Care of Older Adults - Medication Review
- Care of Older Adults - Functional Status Assessment
- Care of Older Adults - Pain Assessment
PROVIDER RESOURCES
- Targeted Quality Measures Provider Guide
- HRM Lab Coat Card
- CAHPS - Consumer Assessment of Healthcare Providers and Systems
CONTACT US
ATRIO Health Plans Quality Improvement