| Msr. Type |
Code | CMS Id | Weight | Measure | Avg. Score | Avg. Star |
|---|---|---|---|---|---|---|
| HED | BCS | C01 | 1 | Breast Cancer Screening | 75 | 3.5 |
| HED | COL | C02 | 1 | Colorectal Cancer Screening | 74 | 3.9 |
| CAH | FLU | C03 | 1 | Annual Flu Vaccine | 73 | 3.2 |
| HOS | PHL | C04 | 3 | Improving or Maintaining Physical Health | 69 | 3.2 |
| HOS | MHL | C05 | 3 | Improving or Maintaining Mental Health | 82 | 3.3 |
| HOS | MPA | C06 | 1 | Monitoring Physical Activity | 52 | 3.5 |
| HED | ABA | C07 | 1 | Adult BMI Assessment | 97 | 4.3 |
| CMS | SNPCM | C08 | 1 | Special Needs Plan (SNP) Care Management | 71 | 3.4 |
| HED | COAMR | C09 | 1 | Care for Older Adults Medication Review | 92 | 4.3 |
| HED | COAFS | C10 | 1 | Care for Older Adults Functional Status Assessment | 87 | 4 |
| HED | COAPS | C11 | 1 | Care for Older Adults Pain Assessment | 93 | 4.5 |
| HED | OMW | C12 | 1 | Osteoporosis Management in Women who had a Fracture | 48 | 3.1 |
| HED | CDCEYE | C13 | 1 | Diabetes Care Eye Exam | 75 | 3.8 |
| HED | CDCNPH | C14 | 1 | Diabetes Care Kidney Disease Monitoring | 96 | 4.2 |
| HED | CDCA1C | C15 | 3 | Diabetes Care Blood Sugar Controlled | 80 | 4.2 |
| HED | ART | C16 | 1 | Rheumatoid Arthritis Management | 79 | 3.6 |
| HOS | FRM | C17 | 1 | Reducing the Risk of Falling | 58 | 3 |
| HOS | BLA | C18 | 1 | Improving Bladder Control | 45 | 3.2 |
| HED | MPR | C19 | 1 | Medication Reconciliation Post-Discharge | 65 | 3 |
| HED | SPC | C20 | 1 | Statin Therapy for Patients with Cardiovascular Disease | 81 | 3.1 |
| CAH | GNC | C21 | 2 | Getting Needed Care | 83 | 3.3 |
| CAH | APTQ | C22 | 2 | Getting Appointments and Care Quickly | 78 | 3.4 |
| CAH | SVC | C23 | 2 | Customer Service | 91 | 3.5 |
| CAH | HCQ | C24 | 2 | Rating of Health Care Quality | 86 | 3.3 |
| CAH | RPLA | C25 | 2 | Rating of Health Plan | 86 | 3.2 |
| CAH | COORD | C26 | 2 | Care Coordination | 86 | 3.4 |
| CMS | CCMPL | C27 | 2 | Complaints about the Health Plan | 0.23 | 4.8 |
| CMS | CDSNR | C28 | 2 | Members Choosing to Leave the Plan | 13 | 4 |
| CMS | CIMPR | C29 | 5 | Health Plan Quality Improvement | - | 3.2 |
| CMS | CTIME | C30 | 2 | Plan Makes Timely Decisions about Appeals | 95 | 4.3 |
| CMS | CFAIR | C31 | 2 | Reviewing Appeals Decisions | 93 | 4.5 |
| CMS | CLANG | C32 | 2 | Call Center Foreign Language Interpreter and TTY Availability | 94 | 4.3 |
| CMS | DLANG | D01 | 2 | Call Center Foreign Language Interpreter and TTY Availability | 94 | 4.4 |
| CMS | DTIME | D02 | 2 | Appeals Auto - Forward | 3.9 | 4.2 |
| CMS | DFAIR | D03 | 2 | Appeals Upheld | 90 | 3.6 |
| CMS | DCMPL | D04 | 2 | Complaints about the Drug Plan | 0.23 | 4.8 |
| CMS | DDSNR | D05 | 2 | Members Choosing to Leave the Plan | 13 | 4 |
| CMS | DIMPR | D06 | 5 | Drug Plan Quality Improvement | - | 3.5 |
| CAH | DRDRG | D07 | 2 | Rating of Drug Plan | 85 | 3 |
| CAH | GETRX | D08 | 2 | Getting Needed Prescription Drugs | 90 | 3.5 |
| CMS | MPF | D09 | 1 | MPF Price Accuracy | 99 | 4.9 |
| PQA | DIAB | D10 | 3 | Medication Adherence for Diabetes Medications | 84 | 3.7 |
| PQA | HTN | D11 | 3 | Medication Adherence for Hypertension (RAS antagonists) | 85 | 3.2 |
| PQA | CHOL | D12 | 3 | Medication Adherence for Cholesterol (Statins) | 84 | 3.3 |
| CMS | MTM | D13 | 1 | MTM Program Completion Rate for CMR | 81 | 3.7 |
| PQA | SUPD | D14 | 3 | Statin Use in Persons with Diabetes (SUPD) | 82 | 3.1 |
| Name | URL |
|---|---|
| Part C & D performance data ® | https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrugcovgenin/performancedata.html |
| HEDIS ® | http://www.ncqa.org/hedis-quality-measurement/hedis-measures |
| 2019 Final Rule | https://www.federalregister.gov/d/2019-06822/p-964 |
| CY 2022 MA Announcement | https://www.cms.gov/files/document/2022-announcement.pdf |
| 2024 MA Final Rule | https://www.federalregister.gov/d/2023-07115/p-1427 |
| 2022 Final Rule | https://www.federalregister.gov/d/2021-00538/p-690 |
| 2025 MA Final rule | https://www.federalregister.gov/documents/2024/04/23/2024-07105/medicare-program-changes-to-the-medicare-advantage-and-the-medicare-prescription-drug-benefit |
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