Quality Stars and Payments Ought to be Earned

by Ceci Connolly

The federal government rates Medicare Advantage plans using a star system that evaluates clinical quality, patient satisfaction and regulatory compliance. This star rating system is designed to help America’s seniors evaluate the quality of their health care options. And it has successfully incentivized health plans to coordinate care and improve outcomes.

While MA plans are administered by private organizations, the program remains highly regulated by the Centers for Medicare and Medicaid Services and is subject to similar oversight and rules as traditional Medicare. Seniors must receive the same benefits in MA that they would in traditional Medicare.

Unfortunately, millions of seniors are losing out on additional benefits because of a snag in these quality incentive payments. Due to a glitch in how the bonus payment is calculated, some of the highest quality MA plans have not received their full incentive payments as promised.

READ THE FULL OP-ED HERE

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ACHP is the voice of a unique approach in health care today, one that puts the patient at the center with plans and clinical teams collaborating to improve health outcomes and reduce costs. Our advocacy focuses on providing policymakers with tested solutions, rooted in a model that is proven to deliver better value for patients, employers and taxpayers.

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