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:

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

Next 4 Largest: 

HEDIS® is coming up fast. If your organization is still abstracting charts the same way it’s done it for decades, why? Could your team review more charts, improve reliability, get higher scores and get some sleep next April? Of course. Let computers handle more of the tedious work and free up your clinical reviewers to do more clinical reviewing. But isn’t it too late?

BHA Ocular is an abstraction system that uses character recognition to locate po