Here are a few quick reminders about confirmed changes to the 2024 Star Ratings, which will be publicly released in October 2023 following the plan preview in September. Recap of confirmed 2024 Star Ratings (CY 2022) changes Kidney Health Evaluation for Patients with Diabetes (KHE).The National Committee for Quality Assurance (NCQA) is proposing non-substantial changes to the following HEDIS measures, which would be applied to Star Ratings as well:.Care for Older Adults (COA) – Functional Status Assessment and Medication Review.Kidney Health Evaluation for Patients with Diabetes (KED).The following measure and indicator would be added to the Part C measure set:.Polypharmacy Use of Multiple Central Nervous System Active Medications in Older Adults (Poly-CNS).Polypharmacy Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH).Concurrent Use of Opioids and Benzodiazepines (COB).The following measures would be moved from the display page to the Part D measure set:.Here are additional significant changes CMS proposes for the 2026 Star Ratings: We still believe these measures focus on critical aspects of care such as care coordination and access to care from the perspective of enrollees, but taking into consideration additional stakeholder feedback we have received and the effect of the policy on the 2023 Star Ratings, we have reconsidered our position from the June 2020 final rule and now believe these measures currently receive an undue weight in the Star Ratings program. In announcing this change, the agency stated: This would reverse the previous increase that was implemented for the 2023 Star Ratings, which led to these measures comprising 58% of a plan’s overall rating. In the Contract Year 2024 Policy and Technical Changes to the Medicare Advantage Program document released in December 2022, CMS proposed to reduce the weight of patient experience/complaints and access measures from 4x to 2x for the 2026 Star Ratings. Proposed 2026 Star Ratings (CY 2024) changes CMS plans to implement a web-based mode for CAHPS ® surveys and wording clarifications in the 2024 CAHPS survey.Several changes to the frailty and advanced illness exclusion value sets will impact multiple measures.Previously optional exclusions for Controlling Blood Pressure (CBP), Colorectal Cancer Screening (COL), and Kidney Health Evaluation for Patients with Diabetes (KED) will now be required exclusions.The Breast Cancer Screening (BCS) measure will be moved from an administrative measure to an electronic clinical data systems (ECDS)-only measure, mirroring the change to the BCS HEDIS ® measure.The Plan All-Cause Readmissions (PCR) measure will increase in weight from 1x to 3x.Here are the most significant changes the Centers for Medicare & Medicaid Services (CMS) has confirmed for the 2025 Star Ratings: Confirmed 2025 Star Ratings (CY 2023) changes Here’s a quick summary of what’s on the horizon for the 2025 Star Ratings, which are based on the 2023 calendar year (CY 2023), as well as proposed changes for the 2026 Star Ratings (based on CY 2024). Quality departments within Medicare Advantage (MA) plans are poring over the newly released 2024 MA and Part D Advance Notice to determine how Star Ratings measures, weights, and cut points will change-and now must figure out the best strategy for addressing these updates.
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