Star Rating Tracking and Improvement >>
Starting in 2012, the Affordable Care act introduced Medicare Advantage bonuses and rebate levels tied to the Center for Medicare & Medicaid Services (CMS) five star quality rating. During a three-year demonstration project running from 2012-2014, the CMS will issue higher bonus payments to the best performing carriers, while carriers with a rating lower than three stars will be tagged with a “low performing” icon on the Medicare Plan Finder. However, a low star rating has the potential to affect more than just a plan’s reputation.
Lower star ratings can put downward pressure on a plan’s Medical Loss Ratio (MLR) with a mandated minimum MLR of 85% for Medicare Advantage Plans just around the corner in 2014.