Quality Measure Cutting Points Chart
This article explores the details of the 2025 CMS Stars cut points, including the specific changes to key quality measures, the impact on providers, and how patients can make informed decisions during open enrollment. CMS raised the 2025 star cut points across multiple measures, requiring plans to meet higher performance thresholds for top
Some measures have a maximum score of 150 points while the maximum number of points for other measures is 100. For measures that have a maximum score of 150 points, points are determined based on deciles. Nursing homes in the lowest performing decile receive 15 points for the measure. Points increase in
Cut pointsthresholds Thresholds are percentage ranges, also referred to as cut points, used to determine the Star level of a measure based on its pass rate. Exclusions Exclusions are the CMS-determined criteria that exempt a Medicare Advantage member or an event from being included when determining the pass rate of a measure. HEDIS
Note The cut points for the health inspection ratings are recalibrated monthly, however the rating for your facility is held constant until there is a change in your health inspection score. For more detailed information about the health inspection domain and scoring rules, read the 5-Star System Technical User's Guide , pages 2-6.
The January 2025 Care Compare refresh will contain new data for four quality measures that were frozen last year due to the the elimination of section G and the replacement of the related portions of the technical specifications with section GG items. The 4 quality measures are To address these changes in measure specifications, the Continue reading January 2025 Five-Star Changes Coming
Refresher on the CMS Star Rating Cut Points For each quality measure within the Medicare Star Rating program, CMS establishes a set of quotcut pointsquot or thresholds that Medicare Advantage and Part D MA-PD contracts need to meet in order to receive a For comparison, Chart 2 below shows the same figures for the changes between the 2023
Quality Measure Cut Points. The point values for each measure are listed in the 5-star System Technical User's Guide. See Table A3 pages 31-34 Ranges for Point Values using Four Quarter Average The QM star rating is based on the total number of points you receive and where they fall in one of these tables depending on the report time period
Next Cut-Point Goals The minimum goal rate to increase the points earned on each measure. 3. quotGoal Totalquot is a total of all the points if all goals from the Five Star QMs were achieved. C. Five Star Quality Measures Post-Acute Care SS Measures amp Chronic Care LS Measures Description from left to right Tip!
This document - Five Star Quality Rating System Technical Users' Guide State Level Health In spection Cut Point Table - provides the data for the s tate-level cut points for the star ratings included in the health inspection domain. Cut points for the staffing ratings and for the QM ratings have been fixed and do not vary monthly.
MA Star Ratings are a critical measure of the quality and performance of MA plans. The MA Star Ratings cut points are the thresholds CMS has set to evaluate the performance of MA plans. These ratings, ranging from 1 to 5 stars, are based on various quality measures, including clinical outcomes, patient experience, and plan administration.
