Within CMS’s Five-Star Quality Rating System for Medicare Advantage (MA) Part C and Part D programs, the stakes are high. Good ratings yield significant benefits for a plan in the form of bonus payments, the ability to charge more than benchmark payments, and a leg up on marketing to and enrolling new members. An increase of even half a star can have quality bonus impacts of $400 per member per year. Low ratings, in contrast, do not simply mean a plan fails to receive these benefits—it can face civil monetary penalties, suspension of marketing and enrollment activities, or even termination as an MA program.

Read our fact sheet and learn how Cotiviti’s Star Intelligence enables health plans to:

• Access a one-stop shop for HEDIS^® quality and Stars management
• Get a clear view of progress with trending and benchmarking dashboards
• Leverage analytics that offer measure prediction, EOY predictions, trends, and opportunities for growth
• Get reliable insights through predictive cut points built into advanced analytics

HEDIS^® is a registered trademark of the National Committee for Quality Assurance (NCQA).