In the midst of the COVID-19 global pandemic, the Center for Medicare & Medicaid Services (CMS) issued a final rule that implements a subset of the proposals from the February 18, 2020, proposed rule (85 FR 9002) related to Part-C and Part-D  measures. These changes included:

• Not requiring HEDIS and CAHPS measure submission for 2020
  • They will replace the CMS 2020 Star Rating Measures based the on the HEDIS and CAHPS data from 2019.
• Remove the Part-C Rheumatoid Arthritis measure
• Modify the classification of the Statin Use in

On April 6, 2020 CMS announced significant to star ratings changes due to COVID-19:

• HEDIS uses 2018 Dates of Service for 2021 Star Ratings.
• CAHPS uses 2018 Dates of Service for 2021 Star Ratings.
• Possibly of foregoing a 2020 HOS survey and use last year's results for the 2022 and 2023 Star ratings.

In the April Call Letter, CMS confirmed the f

Which CMS MA Star Measures have the hardest cutpoints to achieve?  One can’t just compare the cutpoints directly -- it’s far easier to get 10 more BMIs than 10 more cancer screens. 

There are different ways to answer the question, the simplest is to look at the mean Stars that CMS publishes.  A richer analysis that we find helpful is to use percentiles to normalize the cutpoints across all measures.  Then you can visually compare all cutpoints for all measures at once.

For example the 5 star cutpoint for C04 Improv

One of the largest insurers in the country, a 5-state blue, knew their members were getting high quality care. But their Star Ratings and HEDIS® hybrid scores in Medicare Advantage weren’t showing that.  They asked Baltimore Health Analytics if we could help them and we did.

We have an ongoing engagement, but we wanted to share how we’ve worked together with BHA’s tools to markedly improve their quality scores.  The truth is, we’re more heavily engaged than ever, now working with their other lines of business.  It’s beco