Star ratings coming to ACA plans: 4 things to know

Health insurers selling policies on the ACA exchanges will be required to show star ratings for the first time during the 2020 enrollment period, CMS said Aug. 15.

Four things to know:

1. Under CMS' five-star quality rating system, health plans will display how they scored on a one to five star scale. Five represents the highest quality.

2. The star rating is based on three categories: medical care (how well plans manage members' healthcare); member experience (how well plans satisfy their members); and plan administration (how well the plan is run). Each category has its own rating based on a five-star scale.

3. The quality rating system totals 38 measures, including 28 clinical quality measures and 10 survey-based experience measures.

4. Data used to calculate the star ratings are submitted to CMS by each health plan annually.

View CMS' fact sheet here

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