CMS may alter Medicare Advantage star ratings

The Centers for Medicare & Medicare Services will soon be requesting comments on possible changes to the Medicare Advantage five-star quality rating system, the agency announced this week.

Potential changes may address research findings showing outcomes on 19 quality measures for dual eligibles were worse than those for higher-income beneficiaries enrolled in the same contract. Plans with a high enrollment of dual eligibles often say they're at a disadvantage when compared to other plans, and face lower star ratings that make them miss out on bonuses offered to highly rated plans, according to Modern Healthcare.

“Our partners in Medicare Advantage need to have proper incentives to care for dual-eligibles and lower socioeconomic status individuals,” acting CMS Administrator Andy Slavitt said this week at a Medicare conference.

At the same conference, CMS Deputy Administrator and Director Sean Cavanaugh said possible changes will soon be released for MA's risk adjustment program to address additional issues facing plans who enroll a high number of dual eligibles. The agency will be seeking comments on the proposed changes by “early November,” Cavanaugh said.