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What are the benefits of Star Ratings?

The Star rating system helps Medicare beneficiaries compare and select plans, and plays a key role in financing health care benefits for Medicare Advantage and Medicare Advantage Part D plan members. Financial reimbursements for quality reward high performing plans that bring resources into our region. The resources are used for services for patients, provider quality incentive, and fee schedule enhancements.

The Star rating system benefits both providers and patients by improving:

  • Physician and patient relations
  • Customer experience
  • Patient satisfaction
  • Relationship and collaboration with the health plan
  • Increased awareness of patient safety issues
  • Focus on preventive medicine and early disease detection
  • Support for chronic condition management


How can you achieve excellence?

As a provider, you can have an effect on all aspects of the program – especially quality of care, access to care, and beneficiary satisfaction – by:

  • Encouraging patients to obtain preventive screenings and identifying barriers to care
  • Creating a workflow to identify non-compliant patients at appointments, and utilize provider tools such as Risk Manager™ to detect gaps in care
  • Submitting complete and correct claims with appropriate codes, and including CPT II codes through the Pay for Outcomes program
  • Understanding each measure you influence and how your patients can become compliant
  • Incorporating Health Outcomes Survey (HOS) questions into each visit by talking to patients about physical activity, bladder control, and falls prevention
  • Reviewing the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) survey to determine opportunities for you or your office to have an impact; e.g., getting your patients in for appointments as quickly as possible, reviewing test results and coordination of care