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Code CMS Id Weight Measure Avg. Score Avg. Star
HED BCS C01 1 Breast Cancer Screening 70 3.7 C01HEDBreast Cancer ScreeningHED-BCS
HED COL C02 1 Colorectal Cancer Screening 72 3.8 C02HEDColorectal Cancer ScreeningHED-COL
CAH FLU C03 1 Annual Flu Vaccine 73 3.2 C03CAHAnnual Flu VaccineCAH-FLU
HOS MPA C04 1 Monitoring Physical Activity 51 3.2 C04HOSMonitoring Physical ActivityHOS-MPA
CMS SNPCM C05 1 Special Needs Plan (SNP) Care Management 73 3.3 C05CMSSpecial Needs Plan (SNP) Care ManagementCMS-SNPCM
HED COAMR C06 1 Care for Older Adults- Medication Review 91 4.4 C06HEDCare for Older Adults- Medication ReviewHED-COAMR
HED COAPS C07 1 Care for Older Adults- Pain Assessment 90 4.3 C07HEDCare for Older Adults- Pain AssessmentHED-COAPS
HED OMW C08 1 Osteoporosis Management in Women who had a Fracture 45 2.6 C08HEDOsteoporosis Management in Women who had a FractureHED-OMW
HED CDCEYE C09 1 Diabetes Care- Eye Exam 72 3.7 C09HEDDiabetes Care- Eye ExamHED-CDCEYE
HED CDCNPH C10 1 Diabetes Care- Kidney Disease Monitoring 95 3.9 C10HEDDiabetes Care- Kidney Disease MonitoringHED-CDCNPH
HED CDCA1C C11 3 Diabetes Care- Blood Sugar Controlled 78 4.1 C11HEDDiabetes Care- Blood Sugar ControlledHED-CDCA1C
HED CBP C12 1 Controlling Blood Pressure 71 3.5 C12HEDControlling Blood PressureHED-CBP
HOS FRM C13 1 Reducing the Risk of Falling 56 2.9 C13HOSReducing the Risk of FallingHOS-FRM
HOS BLA C14 1 Improving Bladder Control 46 3.3 C14HOSImproving Bladder ControlHOS-BLA
HED MPR C15 1 Medication Reconciliation Post-Discharge 67 3.4 C15HEDMedication Reconciliation Post-DischargeHED-MPR
HED SPC C16 1 Statin Therapy for Patients with Cardiovascular Disease 84 3.5 C16HEDStatin Therapy for Patients with Cardiovascular DiseaseHED-SPC
CAH GNC C17 4 Getting Needed Care 81 3.4 C17CAHGetting Needed CareCAH-GNC
CAH APTQ C18 4 Getting Appointments and Care Quickly 77 3.5 C18CAHGetting Appointments and Care QuicklyCAH-APTQ
CAH SVC C19 4 Customer Service 90 3.4 C19CAHCustomer ServiceCAH-SVC
CAH HCQ C20 4 Rating of Health Care Quality 86 3.4 C20CAHRating of Health Care QualityCAH-HCQ
CAH RPLA C21 4 Rating of Health Plan 87 3.2 C21CAHRating of Health PlanCAH-RPLA
CAH COORD C22 4 Care Coordination 86 3.5 C22CAHCare CoordinationCAH-COORD
CMS CCMPL C23 4 Complaints about the Health Plan 0.31 4.3 C23CMSComplaints about the Health PlanCMS-C-CMPL
CMS CDSNR C24 4 Members Choosing to Leave the Plan 17 3.5 C24CMSMembers Choosing to Leave the PlanCMS-C-DSNR
CMS CIMPR C25 5 Health Plan Quality Improvement - 2.6 C25CMSHealth Plan Quality ImprovementCMS-C-IMPR
CMS CTIME C26 4 Plan Makes Timely Decisions about Appeals 95 4.5 C26CMSPlan Makes Timely Decisions about AppealsCMS-C-TIME
CMS CFAIR C27 4 Reviewing Appeals Decisions 95 4.4 C27CMSReviewing Appeals DecisionsCMS-C-FAIR
CMS CLANG C28 4 Call Center- Foreign Language Interpreter and TTY Availability 90 4.3 C28CMSCall Center- Foreign Language Interpreter and TTY AvailabilityCMS-C-LANG
CMS DLANG D01 4 Call Center- Foreign Language Interpreter and TTY Availability 90 4.4 D01CMSCall Center- Foreign Language Interpreter and TTY AvailabilityCMS-D-LANG
CMS DCMPL D02 4 Complaints about the Drug Plan 0.31 4.3 D02CMSComplaints about the Drug PlanCMS-D-CMPL
CMS DDSNR D03 4 Members Choosing to Leave the Plan 17 3.5 D03CMSMembers Choosing to Leave the PlanCMS-D-DSNR
CMS DIMPR D04 5 Drug Plan Quality Improvement - 2.7 D04CMSDrug Plan Quality ImprovementCMS-D-IMPR
CAH DRDRG D05 4 Rating of Drug Plan 86 3.2 D05CAHRating of Drug PlanCAH-D-RDRG
CAH GETRX D06 4 Getting Needed Prescription Drugs 90 3.4 D06CAHGetting Needed Prescription DrugsCAH-GETRX
CMS MPF D07 1 MPF Price Accuracy 95 4.2 D07CMSMPF Price AccuracyCMS-MPF
PQA DIAB D08 3 Medication Adherence for Diabetes Medications 86 3 D08PQAMedication Adherence for Diabetes MedicationsPQA-DIAB
PQA HTN D09 3 Medication Adherence for Hypertension (RAS antagonists) 87 3.4 D09PQAMedication Adherence for Hypertension (RAS antagonists)PQA-HTN
PQA CHOL D10 3 Medication Adherence for Cholesterol (Statins) 86 3.1 D10PQAMedication Adherence for Cholesterol (Statins)PQA-CHOL
CMS MTM D11 1 MTM Program Completion Rate for CMR 83 3.9 D11CMSMTM Program Completion Rate for CMRCMS-MTM
PQA SUPD D12 1 Statin Use in Persons with Diabetes (SUPD) 85 3.1 D12PQAStatin Use in Persons with Diabetes (SUPD)PQA-SUPD

MY 2023 Stars Changes

  • Plan All-Cause Readmissions to 3x1,2

MY 2024 Stars Changes

  Program changes

  • 2027 Health Equity Index performance capture starts3

  Weight changes

  • CAHPS measures to 2x (Patient experience, complaints, and access measures)3

 New Measures:3

  • Improving/Maintaining Physical Health (1x)
  • Improving/Maintaining Mental Health (1x)
  • Kidney Health for Patients with Diabetes (1x)

MY 2025 Stars Changes

 Program changes

  • Health Equity Index introduced; RF replaced3

 Weight Changes

  • Improving/Maintaining Physical Health increases to 3x4
  • Improving/Maintaining Mental Health increases to 3x4

 New Measures:5

  • Care for Older Adults—Functional Status Assessment (1x)
  • Concurrent Use of Opioids and Benzodiazepines (COB) (1x)
  • Polypharmacy Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) (1x)

 Retired Measures:5

  • Care for Older Adults – Pain Assessment
  • Medication Reconciliation Post-discharge (MRP)
  • MTM Program Completion Rate for Comprehensive Medication Review (CMR) – Retired to display