The Centers for Medicare and Medicaid Services has released several new Star Ratings methodology changes that are likely to disrupt the status quo in the Medicare Advantage (MA) market. This white paper outlines the financial implications of these changes for the 2025 payment year and beyond, along with steps MAOs can take to be successful in this new system. We discuss:
- The Tukey outlier removal
- 2024 Final Rule announcement
- Health Equity Index (HEI) rewards
- Measure and weight changes
- Hold harmless threshold and other unfinalized rule changes
- Total expected financial impact of Star Rating changes
- What plans can do to succeed