STAR Ratings
CMS quality ratings for Medicare Advantage and Part D prescription drug plans.
Complete Definition
STAR Ratings are CMS's (Centers for Medicare & Medicaid Services) quality rating system for Medicare Advantage (MA) and Part D prescription drug plans, ranging from 1 to 5 stars. STAR Ratings are calculated annually based on up to 50 quality and performance measures including HEDIS measures, patient experience (CAHPS surveys), and plan administration. Plans with 4+ stars receive quality bonus payments from CMS, while low-rated plans face enrollment restrictions. Health Cloud helps health plans improve STAR ratings through automated HEDIS tracking, member engagement campaigns, and care gap closure workflows.
Key Points
- 1CMS quality ratings (1-5 stars)
- 2For Medicare Advantage and Part D plans
- 3Based on 50+ quality and performance measures
- 44+ stars receive CMS bonus payments
- 5Drives member enrollment and revenue
Common Questions
How can Health Cloud help improve STAR ratings?
Health Cloud automates HEDIS measure tracking, identifies member-level care gaps, triggers targeted outreach campaigns, and provides real-time performance dashboards to help health plans close gaps and improve quality measures that drive STAR ratings.
Related Terms
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