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Quality Rating Systems

How does establishing a quality rating system increase the quality of services, facilitate oversight, and help consumers make informed care decisions?

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Quality Payment Program

Policy Definition: CMS is required by law to implement a quality payment incentive program, referred to as the Quality Payment Program, which rewards value and outcomes in one of two ways: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). Performance is measured through the data clinicians report in four areas - Quality, Improvement Activities, Promoting Interoperability (formerly Advancing Care Information), and Cost. source & source

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Medicare Advantage Star Ratings

Policy Definition: Medicare Advantage Plans are evaluated on performance across five categories while Part D plans are rated on four areas. Both highlight things like quality of care and customer service. Plans are rated from one to five stars in all categories, then given one overall rating. source

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learn more at unitedstatesofcare.org

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