Saturday, July 12, 2014

Is Your Organization Prepared to Score 5 STARS this Year?

As mandated by the Affordable Care Act, CMS currently provides a quality bonus payment (QBP) for Medicare Advantage organizations  and Medicare Prescription Drug Plans  based on their five-star ratings. 

For 2015, only those MA plans with a four-star or five-star rating are eligible for the quality bonus.

Is Your Organization Prepared to Score 

5 STARS this Year?

CMS plans to use it's existing regulatory authority to terminate, effective December 31, 2014, contracts with a consistent pattern of low star ratings. Specifically, CMS will terminate those MA-PD contracts that scored a Part C summary rating of less than 3 stars in each of the most recent three consecutive rating periods (i.e., 2013, 2014, 2015 sets of ratings), regardless of their Part D summary rating performance during the same period. 

Ensure that your team has the knowledge they need to 


Continuous Process Improvement is a team sport! 

Do your players have what it takes to score 5 Stars? 

This 10 question quiz reviews enhancements to the 2015 Star Ratings! 

Click on the picture below to play 5 STAR TRIVIA

CMS to Institute 5-star Ratings for Hospitals

The Centers for Medicare & Medicaid Services (CMS), which oversees the Medicare program, recently announced that it plans to implement its Five-Star Rating System for hospitals. The on-line rating system for more than 4,000 Medicare-certified hospitals is expected to be rolled out later this year, according to Dr. Patrick Conway, CMS Deputy Administrator for Innovation and Quality, and Chief Medical Officer. According to Dr. Conway, “The star ratings empower consumers with information to make more informed health care decisions, encourage providers to strive for higher levels of quality, and drive overall health system improvement.” CMS currently uses a five-star system that rates nursing homes and Medicare Advantage plans.

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