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New Report Outlines Upcoming Changes to the Medicare Star Ratings Program

Washington, DC (PRWEB) December 02, 2013

Medicare plans and providers face a crucial task each year: achieve the highest Medicare star ratings possible or face the consequences. With major revenue and competitive positioning at stake — including the possibility of losing Medicare contracts if certain measures earn fewer than three stars for three consecutive years — Medicare Advantage and Medicare Part D prescription drug plans must take every step possible to maximize performance on all of the star rating quality measures. To address this need, industry-leading health business information publisher Atlantic Information Services, Inc. (AIS) is pleased to announce the release of the latest report in its Management Insight Series, Medicare Star Ratings: Key Steps to Prepare for Changes in 2014 and 2015, which examines upcoming changes to the star ratings program as detailed in the 2014 Star Rating Final Call Letter released by CMS earlier this year.

Questions addressed in the report include:

  • Which new measures — and changes to existing measures — will pose the biggest hurdle to Medicare plans?
  • How will the potential change to using percentage scores rather than stars in calculating summary and overall star ratings affect an organization’s score?
  • What steps should organizations take to prepare for 2014 display measures that may be used in calculating star ratings in 2015?
  • Which three high-scoring ratings may CMS move to the display page, where they’ll be collected and monitored but will not be used in calculating star ratings?
  • What other measures are likely to be adopted in the future? How should plans begin preparing for them today?

Medicare Star Ratings also addresses macro-level considerations that CMS has outlined in various recent notices, designed to allow its readers to achieve the highest level star ratings possible on all of CMS’s quality measures. The report includes material from a February 2013 AIS webinar presented by Kristian Marquez, CFA, vice president of the Clinical & Quality Outcomes (C&QO) department at Inovalon, Inc., and April Goss, senior manager, healthcare operations at Inovalon. It has been updated with new data from the Final Call Letter released in April 2013.

For more information on Medicare Star Ratings: Key Steps to Prepare for Changes in 2014 and 2015, including a full table of contents and a PDF of the forward to the report, visit

AIS’s Management Insight Series is designed to provide practical solutions to complex business challenges with the help of the industry’s most insightful advisors and managers. See a full list of titles in this series at

About AIS
Atlantic Information Services, Inc. (AIS) is a publishing and information company that has been serving the health care industry for more than 25 years. It develops highly targeted news, data and strategic information for managers in hospitals, health plans, medical group practices, pharmaceutical companies and other health care organizations. AIS products include print and electronic newsletters, websites, looseleafs, books, strategic reports, databases, webinars and conferences. Learn more at

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