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Type
Code CMS Id Weight Measure Avg. Score Avg. Star
HED FUH DMC01 0 Follow-up Visit after Hospital Stay for Mental Illness (within 30 days of discharge) 49 0 DMC01HEDFollow-up Visit after Hospital Stay for Mental Illness (within 30 days of discharge)HED-FUH
HED AMM DMC02 0 Antidepressant Medication Management (6 months) 66 0 DMC02HEDAntidepressant Medication Management (6 months)HED-AMM
HED CBBT DMC03 0 Continuous Beta Blocker Treatment 89 0 DMC03HEDContinuous Beta Blocker TreatmentHED-CBBT
HED TCCOPD DMC04 0 Testing to Confirm Chronic Obstructive Pulmonary Disease 27 0 DMC04HEDTesting to Confirm Chronic Obstructive Pulmonary DiseaseHED-TCCOPD
CAH DCW DMC05 0 Doctors who Communicate Well 92 0 DMC05CAHDoctors who Communicate WellCAH-DCW
CMS CCBHT DMC06 0 Call Center - Beneficiary Hold Time 45 0 DMC06CMSCall Center - Beneficiary Hold TimeCMS-CCBHT
CAH PV DMC07 0 Pneumonia Vaccine 68 0 DMC07CAHPneumonia VaccineCAH-PV
HED APCDV DMC08 0 Access to Primary Care Doctor Visits 94 0 DMC08HEDAccess to Primary Care Doctor VisitsHED-APCDV
CMS CDCCHP DMC09 0 Call Center - Calls Disconnected When Customer Calls Health Plan 2 0 DMC09CMSCall Center - Calls Disconnected When Customer Calls Health PlanCMS-CDCCHP
HED PMSC DMC10 0 Pharmacotherapy Management of COPD Exacerbation - Systemic Corticosteroid 75 0 DMC10HEDPharmacotherapy Management of COPD Exacerbation - Systemic CorticosteroidHED-PMSC
HED PMB DMC11 0 Pharmacotherapy Management of COPD Exacerbation - Bronchodilator 84 0 DMC11HEDPharmacotherapy Management of COPD Exacerbation - BronchodilatorHED-PMB
HED IADT DMC12 0 Initiation of Substance Use Disorder Treatment 36 0 DMC12HEDInitiation of Substance Use Disorder TreatmentHED-IADT
HED EADT DMC13 0 Engagement of Substance Use Disorder Treatment 5 0 DMC13HEDEngagement of Substance Use Disorder TreatmentHED-EADT
HED IESDTA DMC14 0 Initiation and Engagement of Substance Use Disorder Treatment Average 20 0 DMC14HEDInitiation and Engagement of Substance Use Disorder Treatment AverageHED-IESDTA
HED HPPC DMC15 0 Hospitalization for Potentially Preventable Complications 16 0 DMC15HEDHospitalization for Potentially Preventable ComplicationsHED-HPPC
HED TRCMRP DMC16 0 Transitions of Care - Medication Reconciliation Post-Discharge 64 0 DMC16HEDTransitions of Care - Medication Reconciliation Post-DischargeHED-TRCMRP
HED TRCNIA DMC17 0 Transitions of Care - Notification of Inpatient Admission 32 0 DMC17HEDTransitions of Care - Notification of Inpatient AdmissionHED-TRCNIA
HED TRCAID DMC18 0 Transitions of Care - Patient Engagement After Inpatient Discharge 83 0 DMC18HEDTransitions of Care - Patient Engagement After Inpatient DischargeHED-TRCAID
HED TRCRDI DMC19 0 Transitions of Care - Receipt of Discharge Information 23 0 DMC19HEDTransitions of Care - Receipt of Discharge InformationHED-TRCRDI
HOS PFADL DMC20 0 Physical Functioning Activities of Daily Living 94 0 DMC20HOSPhysical Functioning Activities of Daily LivingHOS-PFADL
HED COAFS DMC21 0 Care for Older Adults - Functional Status 76 0 DMC21HEDCare for Older Adults - Functional StatusHED-COAFS
HED KHEPD DMC22 0 Kidney Health Evaluation for Patients With Diabetes 46 0 DMC22HEDKidney Health Evaluation for Patients With DiabetesHED-KHEPD
HOS PHL DMC23 0 Improving or Maintaining Physical Health2 68 0 DMC23HOSImproving or Maintaining Physical Health2HOS-PHL
HOS MHL DMC24 0 Improving or Maintaining Mental Health2 83 0 DMC24HOSImproving or Maintaining Mental Health2HOS-MHL
HED CRA DMC25 0 Cardiac Rehabilitation - Achievement 4 0 DMC25HEDCardiac Rehabilitation - AchievementHED-CRA
HED CRE1 DMC26 0 Cardiac Rehabilitation - Engagement 1 10 0 DMC26HEDCardiac Rehabilitation - Engagement 1HED-CRE1
HED CRE2 DMC27 0 Cardiac Rehabilitation - Engagement 2 9 0 DMC27HEDCardiac Rehabilitation - Engagement 2HED-CRE2
HED CRI DMC28 0 Cardiac Rehabilitation - Initiation 8 0 DMC28HEDCardiac Rehabilitation - InitiationHED-CRI
DM EDCOL DMC29 0 Colorectal Cancer Screening (Age 45-75) 69 0 DMC29DM-Colorectal Cancer Screening (Age 45-75)DM-HED-COL
CMS CCDP DMD01 0 Call Center - Calls Disconnected When Customer Calls Drug Plan 2 0 DMD01CMSCall Center - Calls Disconnected When Customer Calls Drug PlanCMS-CCDP
CMS BHT DMD02 0 Call Center - Beneficiary Hold Time 42 0 DMD02CMSCall Center - Beneficiary Hold TimeCMS-BHT
CMS MPFS DMD03 0 MPF - Stability 100 0 DMD03CMSMPF - StabilityCMS-MPFS
CMS CCPHT DMD04 0 Call Center - Pharmacy Hold Time 33 0 DMD04CMSCall Center - Pharmacy Hold TimeCMS-CCPHT
CMS PSHPD DMD05 0 Plan Submitted Higher Prices for Display on MPF 74 0 DMD05CMSPlan Submitted Higher Prices for Display on MPFCMS-PSHPD
CAH RFP DMD06 0 Reminders to Fill Prescriptions 54 0 DMD06CAHReminders to Fill PrescriptionsCAH-RFP
CAH RTM DMD07 0 Reminders to Take Medications 33 0 DMD07CAHReminders to Take MedicationsCAH-RTM
PQA APD DMD08 0 Antipsychotic Use in Persons with Dementia (APD) 10 0 DMD08PQAAntipsychotic Use in Persons with Dementia (APD)PQA-APD
PQA APDLTN DMD09 0 Antipsychotic Use in Persons with Dementia - for Long-Term Nursing Home Residents (APD- LTNH) 10 0 DMD09PQAAntipsychotic Use in Persons with Dementia - for Long-Term Nursing Home Residents (APD- LTNH)PQA-APDLTN
PQA COB DMD10 0 Concurrent Use of Opioids and Benzodiazepines (COB) 15 0 DMD10PQAConcurrent Use of Opioids and Benzodiazepines (COB)PQA-COB
PQA OHD DMD11 0 Use of Opioids at High Dosage in Persons Without Cancer (OHD) 6 0 DMD11PQAUse of Opioids at High Dosage in Persons Without Cancer (OHD)PQA-OHD
PQA OMP DMD12 0 Use of Opioids from Multiple Providers in Persons Without Cancer (OMP) - 0 DMD12PQAUse of Opioids from Multiple Providers in Persons Without Cancer (OMP)PQA-OMP
PQA PMAMOA DMD13 0 Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) 9 0 DMD13PQAPolypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH)PQA-PMAMOA
PQA MAMOA DMD14 0 Polypharmacy: Use of Multiple CNS-Active Medications in Older Adults (Poly-CNS) 13 0 DMD14PQAPolypharmacy: Use of Multiple CNS-Active Medications in Older Adults (Poly-CNS)PQA-MAMOA
PQA IOP DMD15 0 Initial Opioid Prescribing (IOP-LD) 17 0 DMD15PQAInitial Opioid Prescribing (IOP-LD)PQA-IOP
PST INS DMD16 0 Persistence to Basal Insulin (PST-INS) 69 0 DMD16PSTPersistence to Basal Insulin (PST-INS)PST-INS
DR R DME01 0 Grievance Rate 7 0 DME01DR-Grievance RateDR-GR
DR GP DME02 0 Disenrollment Reasons - Problems Getting the Plan to Provide and Pay for Needed Care (MA-PD MA-only) 17 0 DME02DR-Disenrollment Reasons - Problems Getting the Plan to Provide and Pay for Needed Care (MA-PD MA-only)DR-PGP
DR CD DME03 0 Disenrollment Reasons - Problems with Coverage of Doctors and Hospitals (MA-PD MA-only) 22 0 DME03DR-Disenrollment Reasons - Problems with Coverage of Doctors and Hospitals (MA-PD MA-only)DR-PCD
DR RD DME04 0 Disenrollment Reasons - Financial Reasons for Disenrollment (MA-PD MA-only PDP) 21 0 DME04DR-Disenrollment Reasons - Financial Reasons for Disenrollment (MA-PD MA-only PDP)DR-FRD
DR DBC DME05 0 Disenrollment Reasons - Problems with Prescription Drug Benefits and Coverage (MA-PD PDP) 10 0 DME05DR-Disenrollment Reasons - Problems with Prescription Drug Benefits and Coverage (MA-PD PDP)DR-PDBC
DR GIHP DME06 0 Disenrollment Reasons - Problems Getting Information and Help from the Plan (MA-PD PDP) 13 0 DME06DR-Disenrollment Reasons - Problems Getting Information and Help from the Plan (MA-PD PDP)DR-PGIHP
DR APP DME07 0 Beneficiary Access and Performance Problems 86 0 DME07DR-Beneficiary Access and Performance ProblemsDR-BAPP

MY 2023 Stars Changes

  • Plan All-Cause Readmissions to 3x1,2

MY 2024 Stars Changes

  Program changes

  • 2027 Health Equity Index performance capture starts3

  Weight changes

  • CAHPS measures to 2x (Patient experience, complaints, and access measures)3

 New Measures:3

  • Improving/Maintaining Physical Health (1x)
  • Improving/Maintaining Mental Health (1x)
  • Kidney Health for Patients with Diabetes (1x)

MY 2025 Stars Changes

 Program changes

  • Health Equity Index introduced; RF replaced3

 Weight Changes

  • Improving/Maintaining Physical Health increases to 3x4
  • Improving/Maintaining Mental Health increases to 3x4

 New Measures:5

  • Care for Older Adults—Functional Status Assessment (1x)
  • Concurrent Use of Opioids and Benzodiazepines (COB) (1x)
  • Polypharmacy Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) (1x)

 Retired Measures:5

  • Care for Older Adults – Pain Assessment
  • Medication Reconciliation Post-discharge (MRP)
  • MTM Program Completion Rate for Comprehensive Medication Review (CMR) – Retired to display