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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