Why Medicare Advantage Star Ratings Matter

Jacqueline Fellows, for HealthLeaders Media , January 16, 2013

An accompanying editorial on the JAMA study from Jack Hoadley, PhD, from Georgetown University's Health Policy Institute, notes a star rating type system can help control costs and increase quality if it is presented to consumers in a way they can use it.

"In this spirit, it is important to think about better ways to present performance ratings, along with information on costs, to consumers," writes Hoadley.

In the study, the authors suggest that CMS consider "communicating information specific to plans or service areas within the larger, contract-level star rating to enhance their relevance."

"There is no question that we certainly want to continue to raise awareness about star ratings and about public reporting of quality to try to continue to empower and inform our beneficiaries," says Shrank.

Another key take away from the JAMA study suggests that CMS is accomplishing its goal of steering beneficiaries to higher quality health plans by publicly reporting the star quality data. If public reporting of quality data leads Medicare beneficiaries to pick higher quality health plans, then there are important implications for health plans as they begin to decide how to participate and communicate their participation in state health insurance exchanges.

The study's conclusion that the star quality ranking system provides verifiable confirmation of a link between quality and enrollment gives payers "additional justification to pursue higher quality."

It's advice, Shrank says, the healthcare industry as a whole could use.

"In the setting where there may be more public reporting of quality, this helps to build a business context for promoting quality."

Jacqueline Fellows is an editor for HealthLeaders Media.
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