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CMS Star Ratings Calendar

Every year, the Centers for Medicare & Medicaid Services (CMS) releases proposed and confirmed changes to the Star Ratings (SR) program, impacting quality bonus payments for Medicare Advantage plans. Take a look at this newly updated calendar as a reminder of proposed and confirmed upcoming changes to the CMS Star Ratings system for the 2024 Measurement Year (MY) and beyond.

Color code:

Confirmed change

Proposed change

Deferred change

2024 Measurement Year (MY) / 2026 Star Ratings (SR)

Measure changes

Program changes

Medication Adherence measures to update the CE calculation to align with PQA specifications

Remove the 60% rule that is part of the adjustment for extreme and uncontrollable circumstances from the cut points clustering algorithm

Reduce the weight of patient experience/complaints and access measures to 2x

BCS: NCQA is adding transgender and gender diverse members to denominator 

Kidney Health Evaluation (KED) added: 1x weight

COL: Reported as ECDS only

SUPD measure changes to the CE calculation and age criteria to align with PQA specifications

HOS measures: Improving or Maintaining Physical Health and Improving of Maintaining Mental Health return at 1x weight

Poly-CNS, Poly-ACH, and COB measures to align with the PQA measure specifications to use CE and no longer adjust for MYs starting with MY 25/ SY 27 

Update the data source for the Part D measures from the Enrollment Database (EDB) to the Common Medicare Environment (CME) when identifying Hospice and ESRD exclusions

Non-substantive changes to chronic condition identification

2025 MY / 2027 SR

Measure changes

Program changes

Remove Care for Older Adults - Pain Assessment, per NCQA's measure retirement

Add Health Equity Index (HEI) reward and remove Reward Factor based on MY2024 and MY2025 data

Remove the standalone Medication Reconciliation Post-Discharge (Part C) measure

Modify the Improvement Measure hold harmless policy to apply only to 5-star plans

COL: Age range expanded to include ages 45-49

COA Functional Status Assessment added: 1x weight

Part D Concurrent Use of Opioids and Benzodiazepines (COB) added: 1x weight

Polypharmacy: Use of Anticholinergic Medications in Older Adults (Poly-ACH) added: 1x weight

SPC: Add Statin intolerance exclusion

HOS measures: Improving or Maintaining Physical Health and Improving of Maintaining Mental Health increase weight to 3x

MTM Program Completion Rate for CMR moved to display page for MY 25/MY 26.  Will return to Star Ratings as new measure in MY 27.

Remove hybrid reporting from CDC-Eye Exam (to mirror NCQA)

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2026 MY / 2028 SR

Measure changes

Program changes

Non-risk-adjusted Medication Adherence measures retired.  Risk-adjusted Medication Adherence measures added: 1x weight

Remove guardrails for non-CAHPS measures

Medication Adherence measures to remove the adjustment for IP or SNF stays to align with PQA specifications

Adding Initial Opioid Prescribing for Long Duration (IOP-LD) to the part D measures

Add Initiation and Engagement of Substance Use Disorder Treatment (IET) as an average of Initiation and Engagement rates

Retire SPC (to align with NCQA).  A replacement measure with substantive changes would first be on the display page for two years.

2027 MY / 2029 SR

Measure changes

Program changes

Risk-adjusted Med Adherence measures increase to 3x weight

Health Equity Index: Add geography
(e.g., rural or urban) as a Social Risk Factor (SRF).  No date specified.

Retire legacy Appeals measures (Plan Makes Timely Decisions about Appeals, Reviewing Appeals Decisions).  Respecified Appeals measures would move into the Star Ratings program in SY 2029 (after 2 years on Display). 

Health Equity Index: changes to HEI calculation after consolidations and exclusively aligned enrollment

Retire MPF Price Accuracy.  No date specified.

Retire Complaints about the
Health and Drug Plan (Part C and D).  No date specified.

Retire Call Center – Foreign Language Interpreter and TTY Availability (Part C and D).  No date specified.

Retire Plan Makes Timely Decisions about Appeals (Part C).  No date specified.

Retire Reviewing Appeals Decisions (Part C).  No date specified.

Retire Medication Therapy Management (MTM) Program Completion Rate for Comprehensive Medication Review (CMR) (Part D) and/or Special Needs Plan (SNP) Care Management (Part C).  No date specified.

Retire SNP-specific measures: Care for Older Adults – Medication Review and Care for Older Adults – Functional Status Assessment.  No date specified.

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