What is the HEI?

 The HEI is a proposed bonus ranging from 0 to 0.4 added directly to each plan’s raw star rating based on two things: (1) the percentage of members that either are disabled or have Low Incoming Subsidy or Dual Eligibility, and (2) the number of measures in which the plan scored well for this subset of members.

Please navigate to https://baltimorehealthanalytics.com/websiteblog/tutorial/health-equity-index to read the full content!

Medicare Advantage: Unveiling the 2025 Proposed Rule by CMS! 

The Centers for Medicare & Medicaid Services (CMS) recently released the 2025 Medicare Advantage (MA) Proposed Rule.

In the proposed Rule places a spotlight on critical aspects, demonstrating CMS's commitment to improving health equity, restricting broker marketing practices, and expanding access to behavioral health services. We also saw some important announcements related to Star ratings!

Diving into the proposed Stars changes: What You

 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.

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!

I received this email last week:

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: