HOS: More Than Just the Other Survey

Over the last four cycles of the CMS Stars program, the 4 Star cut points for the HOS and CAHPS-based measures have remained relatively stable. Since 2017, some measures such as Improving or Maintaining Mental Health have seen a slight decline from a score of 85 to 82...

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Navigating Plan Preview in a Pandemic

Navigating Plan Preview in a Pandemic

On August 7, the 2021 Star Ratings kicked off with the announcement of the first plan preview. This marks the first time that official performance data on all scored measures are presented in a single report. This year CMS is allowing plans two...

Maximizing Medicare Advantage Bid Budget

Maximizing Medicare Advantage Bid Budget

Bids for Medicare Advantage and standalone prescription drug plans have been submitted for the 2021 plan year. This was no small undertaking for health plans given the regulation changes from CMS and the COVID-19 pandemic. Unfortunately, the work...

CAHPS Usurps HEDIS as King

CAHPS Usurps HEDIS as King

For Medicare Advantage plans, the HEDIS-based measures have been the focal point of the Star Rating Program for years. Even as CMS made changes to the program, strong performance in these measures was essentially a formula to reach a 4-Star Rating....