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Insurance Groups Express Concern on How CMS Plans to Calculate MA Star Ratings for 2021, 2022

Fierce Healthcare writes of concerns among several insurer groups and individual payers about how CMS plans to calculate the star ratings for the 2021 and 2022 plan years, which affect reimbursement for plans.

CMS paused the ongoing data collection surveys used to calculate the 2021 star ratings, including the Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Healthcare Effectiveness Data and Information Set (HEDIS), to lower the administrative burden for providers overwhelmed with the COVID-19 pandemic. CMS will use the scores from the 2020 star ratings to apply to the 2021 year. However, the insurance lobbying group America’s Health Insurance Plans was concerned that the consumer assessment survey measures will carry a greater weight for the 2021 star ratings compared to this year.

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