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Health Equity Index

Posted By: suruthi Suruthi K  On : January 06 2023

BHA interprets what CMS is proposing in the Rule for the new Health Equity Index, how it's calculated and what it means for Medicare Advantage Plans.  More plans receive an HEI Reward Factor than the legacy Reward Factor, but the average reward size is smaller.

 

 

Update

1/17/23 - Added more details about the median and half median.  CMS provides these figures -41.6% and 20.8% on page 565.

 

Context

In the recent Proposed Rule, CMS listed a number of sweeping changes to Medicare Advantage Star Ratings.  Some of the key provisions are:<

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Reward Factor Analysis

Posted By: suruthi Suruthi K  On : December 12 2022

 The importance of the Reward Factor for acheiving 4.5 and 5 Stars in the Medicare Advantage Star Ratings system.

 Author’s Note

DUOS invited me to join Eric Santa and Martha Osos in writing their December 2022 Insight Briefing in which we showed the importance of the Reward Factor in Medicare Advantage Star Ratings.  This blog is a companion “deep dive” into the math that didn’t belong in the briefing format.

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Update on CMS 2023 Cutpoints

Posted By: suruthi Suruthi K  On : September 09 2022

 

 

2023 Cutpoints are Up! You can find all of 2023 cutpoints in BHA's measure browser w/graphs to show the long term trends. Especially check out what's happening with Medication Adherence.

 

Click on this link to explore the cutpoints changes Measure Details 2023

 

Email us for additional information, a live demo of our software, and assistance in charting your path to 4 (or more) Stars!

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Why is everyone sweating about 2023 Stars?

Posted By: suruthi Suruthi K  On : September 01 2022

 

I received this email last week:

 

Subject: Quick Stars Question

 

I’ve heard from several health plans with concerns over Stars scores falling off next year. Is there anything explicitly related to the Public Health Emergency that caused Stars scores to increase this year? Or was CMS just more favorable with scoring / cutoffs given COVID concerns.

 

My quick response was:

 

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Medicare Advantage Plans Year Over Year Star Ratings by Size

Posted By: suruthi Suruthi K  On : October 26 2021

  

4 Largest Organizations:  United Health, Humana, CSV-Aetna, and Kaiser

Next 4 Largest

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