Medicare Advantage star ratings: Basics and best practices

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By Dustin J. Grzeskowiak, Patricia A. Zenner | 08 November 2017
The Centers for Medicare and Medicaid Services (CMS) intends star ratings to grade Medicare plan quality. Initially, CMS published star ratings to help Medicare beneficiaries choose quality plans. Since 2012, CMS has also tied plan revenue and other incentives to star ratings. This article provides an overview of CMS’s methodology for calculating star ratings, introduces the financial and marketing implications of star ratings for Medicare plans, and summarizes best practices common to high-rated plans.