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Type
Code CMS Id Weight Measure Avg. Score Avg. Star
HED BCS C01 1 Breast Cancer Screening 74 3.2 C01HEDBreast Cancer ScreeningHED-BCS
HED COL C02 1 Colorectal Cancer Screening 71 3.8 C02HEDColorectal Cancer ScreeningHED-COL
CAH FLU C03 1 Annual Flu Vaccine 66 3.2 C03CAHAnnual Flu VaccineCAH-FLU
HOS PHL C04 1 Improving or Maintaining Physical Health 71 3.2 C04HOSImproving or Maintaining Physical HealthHOS-PHL
HOS MHL C05 1 Improving or Maintaining Mental Health 84 3.2 C05HOSImproving or Maintaining Mental HealthHOS-MHL
HOS MPA C06 1 Monitoring Physical Activity 50 3.1 C06HOSMonitoring Physical ActivityHOS-MPA
CMS SNPCM C07 1 Special Needs Plan (SNP) Care Management 76 3.5 C07CMSSpecial Needs Plan (SNP) Care ManagementCMS-SNPCM
HED COAMR C08 1 Care for Older Adults - Medication Review 94 4.2 C08HEDCare for Older Adults - Medication ReviewHED-COAMR
HED COAPS C09 1 Care for Older Adults - Pain Assessment 94 3.9 C09HEDCare for Older Adults - Pain AssessmentHED-COAPS
HED OMW C10 1 Osteoporosis Management in Women who had a Fracture 45 2.8 C10HEDOsteoporosis Management in Women who had a FractureHED-OMW
HED CDCEYE C11 1 Diabetes Care - Eye Exam 77 3.4 C11HEDDiabetes Care - Eye ExamHED-CDCEYE
HED CDCA1C C12 3 Diabetes Care - Blood Sugar Controlled 84 3.6 C12HEDDiabetes Care - Blood Sugar ControlledHED-CDCA1C
HED CDCNPH C13 1 Kidney Health Evaluation for Patients with Diabetes 61 3.4 C13HEDKidney Health Evaluation for Patients with DiabetesHED-CDCNPH
HED CBP C14 3 Controlling Blood Pressure 79 3.4 C14HEDControlling Blood PressureHED-CBP
HOS FRM C15 1 Reducing the Risk of Falling 58 2.7 C15HOSReducing the Risk of FallingHOS-FRM
HOS BLA C16 1 Improving Bladder Control 45 2.8 C16HOSImproving Bladder ControlHOS-BLA
HED MPR C17 1 Medication Reconciliation Post-Discharge 77 3.8 C17HEDMedication Reconciliation Post-DischargeHED-MPR
HED PCR C18 3 Plan All-Cause Readmissions 10 2.9 C18HEDPlan All-Cause ReadmissionsHED-PCR
HED SPC C19 1 Statin Therapy for Patients with Cardiovascular Disease 87 3.3 C19HEDStatin Therapy for Patients with Cardiovascular DiseaseHED-SPC
HED TRC C20 1 Transitions of Care 63 3.1 C20HEDTransitions of CareHED-TRC
HED FMC C21 1 Follow-up after ED Visit People with Multiple Chronic Conditions 61 2.8 C21HEDFollow-up after ED Visit People with Multiple Chronic ConditionsHED-FMC
CAH GNC C22 2 Getting Needed Care 81 3.4 C22CAHGetting Needed CareCAH-GNC
CAH APTQ C23 2 Getting Appointments and Care Quickly 84 3.5 C23CAHGetting Appointments and Care QuicklyCAH-APTQ
CAH SVC C24 2 Customer Service 90 3.5 C24CAHCustomer ServiceCAH-SVC
CAH HCQ C25 2 Rating of Health Care Quality 87 3.4 C25CAHRating of Health Care QualityCAH-HCQ
CAH RPLA C26 2 Rating of Health Plan 87 3.4 C26CAHRating of Health PlanCAH-RPLA
CAH COORD C27 2 Care Coordination 87 3.5 C27CAHCare CoordinationCAH-COORD
CMS CCMPL C28 2 Complaints about the Health Plan 0.24 4.1 C28CMSComplaints about the Health PlanCMS-C-CMPL
CMS CDSNR C29 2 Members Choosing to Leave the Plan 16 3.7 C29CMSMembers Choosing to Leave the PlanCMS-C-DSNR
CMS CIMPR C30 5 Health Plan Quality Improvement - 3.5 C30CMSHealth Plan Quality ImprovementCMS-C-IMPR
CMS CTIME C31 2 Plan Makes Timely Decisions about Appeals 98 4.1 C31CMSPlan Makes Timely Decisions about AppealsCMS-C-TIME
CMS CFAIR C32 2 Reviewing Appeals Decisions 97 3.7 C32CMSReviewing Appeals DecisionsCMS-C-FAIR
CMS CLANG C33 2 Call Center - Foreign Language Interpreter and TTY Availability 97 4.2 C33CMSCall Center - Foreign Language Interpreter and TTY AvailabilityCMS-C-LANG
CMS DLANG D01 2 Call Center - Foreign Language Interpreter and TTY Availability 98 4.4 D01CMSCall Center - Foreign Language Interpreter and TTY AvailabilityCMS-D-LANG
CMS DCMPL D02 2 Complaints about the Drug Plan 0.25 4.1 D02CMSComplaints about the Drug PlanCMS-D-CMPL
CMS DDSNR D03 2 Members Choosing to Leave the Plan 16 3.7 D03CMSMembers Choosing to Leave the PlanCMS-D-DSNR
CMS DIMPR D04 5 Drug Plan Quality Improvement - 3.4 D04CMSDrug Plan Quality ImprovementCMS-D-IMPR
CAH DRDRG D05 2 Rating of Drug Plan 87 3.3 D05CAHRating of Drug PlanCAH-D-RDRG
CAH GETRX D06 2 Getting Needed Prescription Drugs 90 3.5 D06CAHGetting Needed Prescription DrugsCAH-GETRX
CMS MPF D07 1 MPF Price Accuracy 98 4.6 D07CMSMPF Price AccuracyCMS-MPF
PQA DIAB D08 3 Medication Adherence for Diabetes Medications 87 3.1 D08PQAMedication Adherence for Diabetes MedicationsPQA-DIAB
PQA HTN D09 3 Medication Adherence for Hypertension (RAS antagonists) 89 3.3 D09PQAMedication Adherence for Hypertension (RAS antagonists)PQA-HTN
PQA CHOL D10 3 Medication Adherence for Cholesterol (Statins) 89 3.2 D10PQAMedication Adherence for Cholesterol (Statins)PQA-CHOL
CMS MTM D11 1 MTM Program Completion Rate for CMR 91 3.7 D11CMSMTM Program Completion Rate for CMRCMS-MTM
PQA SUPD D12 1 Statin Use in Persons with Diabetes (SUPD) 88 3.3 D12PQAStatin Use in Persons with Diabetes (SUPD)PQA-SUPD

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