Advanced Star Ratings
CMS uses this statistical method to remove extreme values when setting measure thresholds.
What is Tukey outlier deletion?
To meet compliance for this blood pressure control measure, a member's most recent reading must be at or below this threshold.
What is 140/90 mm Hg?
CAHPS measures account for this approximate percentage of the overall Star Ratings weight in 2026.
What is 22%?
These reports released by CMS allow plans to compare performance nationally by percentile.
What are the Star Ratings Technical Notes or Public Use Files (PUFs)?
This federal rule governs many of the Star Rating calculation changes and introduces new regulations.
What is the CMS Final Rule for Medicare Advantage and Part D?
Plans with consistently high performance can receive this type of CMS designation.
What is High Performing Icon (HPI)?
This is the difference between the denominators used for SUPD and SPC.
What is SUPD includes diabetics 40–75 years, SPC includes members with CVD 40–75 years (regardless of diabetes)?
The shift to Weight 4 for CAHPS was introduced in this Star Ratings year and had what primary intended effect?
What is 2023; it elevated the impact of member experience on overall contract ratings?
This machine learning technique predicts the likelihood that a member will close a gap based on past behavior and demographic factors.
What is a propensity model or predictive modeling?
Plans with poor performance for 3+ consecutive years face this CMS sanction.
What is possible contract termination or enrollment sanctions?
How many consecutive years of data must CMS have on a new measure before it becomes included in the Star Ratings?
What is 3 years?