CMS Star Rating

 What Are CMS Star Ratings?

The Centers for Medicare & Medicaid Services (CMS) uses a five-star quality rating system to measure Medicare beneficiaries’ experience with their health plans and the health care system. This rating system applies to Medicare Advantage plans that cover both health services and prescription drugs (MA-PD).

The ratings are posted on the CMS consumer website, www.medicare.gov, to give beneficiaries help in choosing an MA and MA-PD plan offered in their area. The Star Rating program is designed to promote improvement in quality and recognize primary care providers for demonstrating an increase in performance measures over a defined period of time.

CMS’s Star Rating Program is based on measures in nine (9) different domains

  1. Staying healthy: screenings, tests and vaccines
  2. Managing chronic (long-term) conditions
  3. Member experience with the health plan
  4. Member complaints, problems getting services and improvement in the health plan’s performance
  5. Health plan customer service
  6. Drug plan customer service
  7. Member complaints and changes in the drug plan’s performance
  8. Member experience with the drug plan
  9. Drug safety and accuracy of drug pricing

Last Updated: 09302016
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