Quality "Star" Ratings
Because every beneficiary counts.
Under the health reform legislation, payment to Medicare Advantage plans is linked to a beneficiary’s experience and quality of care.
For the first time, high performing plans will be paid more than lower performing plans. This changes the terms of market competition and turns incentives in Medicare Advantage towards improving quality.
It’s comparable to the full phase-in of risk adjustment in 2007, which turned attention from avoiding sick beneficiaries to enrolling all beneficiaries regardless of health status. With the CMS star rating system as the new industry rallying point, plans can realize substantial payment increases by improving quality.
Under the Patient Protection and Affordable Health Care Act (ACA), plans have an imperative to turn their attention to quality performance. By improving quality, plans can realize substantial payment increases that in many cases are close to offsetting reductions they face as a result of payment changes under the law.
Read more about GHG’s Star Ratings service areas.
For more information on how GHG can help your plan create an action plan to improve its quality ratings, contact us today at 202.364.8283 or at ghg@gormanhealthgroup.com.
