CMS Star Rating Measures:
Each year, the Centers for Medicare & Medicaid Services (CMS) uses a Star Ratings system to measure the performance of all Medicare Advantage Part C and Part D Prescription Drug Plans to determine if they provide high-quality care for their members.
These quality scores include several factors, such as the clinical care members receive, their service experience, and member feedback gathered annually detailing how well plans did in various categories. Using a one to five Star Ratings system, CMS evaluates nearly 40 quality and performance measures.
Centene drives CMS Star Ratings performance within five categories:
- Admin/Ops (service quality)
- CAHPS (member satisfaction)
- HEDIS (clinical services)
- HOS (Health Outcomes Survey)
- Pharmacy (taking prescribed medications)
Achieving positive quality ratings is vital. These ratings are crucial to our members, brokers, and partners, and to our overall growth at Wellcare. With CMS' increased focus on patient experience and access to care, we must continue to put our members first and empower them to partner with their providers to make good healthcare decisions.
As always, we thank you for your continued partnership!
