Best Practice Disease Management

CMS uses the five-star rating system to monitor plans to ensure they meet Medicare quality standards. It also allows beneficiaries to compare plans based on quality of care and customer service.

The star ratings for 2011 Medicare Advantage and drug plans for seniors will serve as the basis for a quality bonus payment in a three-year demonstration for MA plans that starts in 2012.

Plans have been working under this system for several years but starting in 2012, the rating is tied to payment, as was specified in the Patient Protection and Affordable Care Act.

The system considers more than 50 measures, such as success in providing preventive health services and managing chronic illnesses in an effort to provide increased care to Medicare Advantage beneficiaries.