CMS will use 30 measures to calculate its 2022 Star Ratings for Medicare Advantage plans, which the agency outlined Jan. 15.
CMS ranks Medicare Advantage on a quality scale of one to five stars, with five representing excellent performance and one reflecting poor performance. To assign stars, Medicare analyzes how health plans perform on certain measures. At the contract level, CMS only includes the measure if numeric value scores are available for both the current year and prior years.
The 30 measures that will be used to calculate the 2022 Star Ratings for Medicare Advantage plans are below. Several of the values aren't included in the Categorical Adjustment Index, which CMS introduced in 2017 to account for how socioeconomic factors affect Star Ratings.
1. Breast cancer screening
2. Colorectal cancer screening
3. Annual flu vaccine
4. Improving or maintaining physical health
5. Improving or maintaining mental health
6. Monitoring physical activity
7. Special Needs Plan (SNP) care management
8. Care for older adults — medication review
9. Care for older adults — pain assessment
10. Osteoporosis management in women who had a fracture
11. Diabetes care — eye exam
12. Diabetes care — kidney disease monitoring
13. Diabetes care — blood sugar controlled
14. Rheumatoid arthritis management
15. Reducing the risk of falling
16. Improving bladder control
17. Medication reconciliation post-discharge
18. Getting needed care
19. Getting appointments and care quickly
20. Customer service
21. Rating of healthcare quality
22. Rating of health plan
23. Care coordination
24. Complaints about the health plan
25. Members choosing to leave the plan
26. Health plan quality improvement
27. Plan makes timely decisions about appeals
28. Reviewing appeals decisions
29. Call center — foreign language interpreter and text-based telecommunication availability
30. Statin therapy for patients with cardiovascular disease
View a full list of the measures here.