![]() Member (customer) experience represents a large portion of the overall star, at 20.6% in 2022. The average Star Rating across MA-PD contracts for 2022 rose to 4.37, up from 4.06 in 2021 and 4.16 in 2020. CMS reported that 90% of beneficiaries in Medicare Advantage Part D (MA-PD) are enrolled in plans receiving four or five stars for 2022, the agency’s top scores for quality. Scoring in determined by county and thus can vary by MAO depending on the specific county performance and data. Since 2012, the overall MA star rating/score have increased, from 3.18 in 2012 to 4.06 in 2018 on average. Then there is the health plans who fail to perform and they are penalized or risk contract termination for consistently low ratings. Comparing the per member (enrollee) MA plan bonus, it was $184 in 2015 and in 2021, it was $446 per member. In addition, Quality Bonus Payments can result in higher rebates that allow the MAOs to provide additional supplemental benefits and lower premiums. The CMS 2022 report indicates that Plans that scored 4 Stars or higher are eligible for a 5% Quality Bonus Payment or QBP. Yes, there is a monetary bonus payment associated with the star ratings, thus MAO (plans) and their providers work very closely to address and meet the measures. C15 Diabetes Care – Blood Sugar Controlled.C14 Diabetes Care – Kidney Disease Monitoring.C12 Osteoporosis Management in Women who had a Fracture.C11 Care for Older Adults – Pain Assessment.C10 Care for Older Adults – Functional Status Assessment.C09 Care for Older Adults – Medication Review.C08 Special Needs Plan (SNP) Care Management.C05 Improving or Maintaining Mental Health. ![]() C04 Improving or Maintaining Physical Health.Here is a list of the first fifteen specific measures for Part C: Health plan customer service: Includes how well the plan handles member appeals.Includes how much the plan’s performance has improved (if at all) over time. ![]() ![]()
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