Providers:

AARM Health provides the following solution related to the provider

Medicare STAR Basics:

• The STAR Rating Program is a “CMS” rubric to assess health plan quality and member satisfaction across Medicare Advantage Plan.
• Plans are rated on a scale of 1 star (poor) and 5 start(Excellent)
• 4 starts and higher receives the annual quality bonus payment
• Performance is based on ~40 measures, which are scored on an industry curve.

Managing HEDIS Scores:

• EACH HEDIS measures clearly specifies the characteristics, demographics, and conditions that make a member eligible to be included in the measure (i.e. the Denominator)
• Similarly, each measure has a clear list of actions and required supporting documents to determine if a member is successfully compliant with the measure (i.e. the Numerator)
• The ratio of Numerators to Denominators ultimately determine a plan’s success within a particular measure, but actual calculations vary by measure type:
• Administrative Measures: performance based on all eligible members.
• Hybrid and Chart Review Measures: performance based on a sample of eligible members.