CMS is changing Star Ratings.  The Member Experience and Access categories are jumping from 1.5x to 2.0x this fall.  That’s significant, but the really big news in the Final Rule released on Friday May 22 (2020) is that they’ll be jumping again to 4x next year.  What will the impact of that move be?  Read on to learn more.

BHA Ocular uses character recognition to search for keywords in charts to take your abstractors directly to the relevant pages and allows them to quickly adjudicate charts in line.  We will be hosting a demo of the product on Webex on Friday June 12th from 2-3 pm ET.   Some features of Ocular include:

• Faster Abstraction
• Less Typing
• Ease of use
• Machine guidance
• Flexibility
• Fast 100% Overread 
• Supplemental Data Options
• Browser Based Tool 
• Keeps Records In House

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