Part-C 2019 Cut Points

The graphs below display the 2018 to 2019 percent change of cut-points for each measure in Part-C, displaying a separate graph for each Star Rating. The red bars pictured represent data for measures increasing in difficulty, i.e. higher thresholds; while green bars will represent data related to lower thresholds. Numerous factors may alter a measure’s outcome for a health plan. Therefore, it is important to analyze these changes for opportunities to improve measure scores and overall performance.

2 Stars

The most noticeable change for the 2-star cut-points occurred with C09 – Care for Older Adults Medication Review. During 2018, the cut-point was set at 59% to reach 2 stars, but for 2019 that same score would garner only 1 star. This created a huge outlier in the data set because it represented the largest change of all the 2-star values for Part-C. Another notable cut-point change was seen with C10 – Care for Older Adults Functional Status Assessment with -70% decrease in difficulty. Lastly, C21 – Plan All Cause Readmissions and C30 – Members Choosing to Leave the Plan both decreased in difficulty by 50%.  The major increase in difficulty for 2 stars cut points occurred with C20 – Medication Reconciliation Post Discharge with a 48% increase.

 

3 stars

For the 3 Stars cut-point C09 – Care for Older Adults-Functional Status Assessments and C-29 Complaints About Health Plan showed a 46% and 70% decrease in difficulty. Again, we see C20 – Medication Reconciliation Post Discharge with a 31% increase in difficulty. In addition, C30 - Members Choosing to Leave Health Plan and C34 - Call Center Foreign Language Interpreter and TTY Availability both increased by 25%. 

 

 

4 stars

As for thresholds related to 4 stars, the major changes occurred with C29 – Complaints About the Health Plan with a 72% decrease in difficulty. To a lesser extent we see 18% decrease in difficulty in C30 – Members Choosing to Leave the Health Plan.

 

 

5 Star

Finally, there is our review of thresholds for Part-C measures for the coveted 5 stars.  C029 - Complaints about the Health Plan had the largest jump amongst all measures. C029 decreased in difficulty by 40% making this measure potentially more obtainable. Following close behind this metric with decreasing difficulty is C30 - Members Choosing to Leave the Plan and C31 - Health Plan Quality Improvement. C30 decreased in difficulty by 33% and C31 by 28%. Alternatively, C21 – Plan All- Cause Readmissions received a 20% increase in difficulty meaning health plans may have to put in extra effort to reach 5 stars for this measure.