Trade Groups Cite Doubts About CMS’s Two Options for Adjusting Stars for SES (with Table: CAI and Indirect Standardization Differ In Approach Across Key Parameters)

From: Medicare Advantage News via AIS Health

By James Gutman, Managing Editor

Trade associations representing Medicare Advantage plans serving disadvantaged populations expressed numerous reservations about the two options CMS last month requested comments on for offering interim relief on star quality ratings for such plans (MAN 12/3/15, p. 1). In their comment letters filed by the Dec. 10 CMS deadline, the associations all thanked CMS for seeking ways to help these financially ailing plan sponsors in the short run, but said they had numerous questions remaining even after a Dec. 3 one-hour CMS conference call on the two options. And they generally voiced doubts about how effective either option would be in granting meaningful relief.

At least one association alluded to another potentially troublesome issue that came up in the agency’s responses on the conference call. Regardless of which option CMS chooses, affected plans may not be able to preview their star ratings for the next year until significantly later in the year than they do now. And if CMS adopts the Indirect Standardization (IS) option, it needs to be based on the current year’s data, adding more uncertainties to the process for insurers.

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