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The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries
The Medicare Advantage 5-Star Rating Program and Its Implications for Actuaries Explanation of Medicare Advantage STAR rating program as it relates to payment rates for MA bids. Also describes ...Description: Explanation of Medicare Advantage STAR rating program as it relates to payment rates for MA bids. Also describes important features of the program from an actuarial perspective, how the components of the STAR rating are calculated and implications and considerations for actuaries.
Hide- Authors: Adrian L Clark, Gabriela Dieguez, Bradley James Piper
- Date: May 2012
- Competency: External Forces & Industry Knowledge>External forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Strategy development; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Health Watch
- Topics: Health & Disability>Health insurance; Health & Disability>Payment models; Public Policy
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Money Matters: Making Medicaid Payment More Effective Through Population-Based Payment
Money Matters: Making Medicaid Payment More Effective Through Population-Based Payment State Medicaid agencies have been implementing value-based payment (VBP) models for the last decade and are ...Description: State Medicaid agencies have been implementing value-based payment (VBP) models for the last decade and are increasingly exploring advanced population-based payment (PBP) models that increase flexibility, predictability, and accountability for participating provider organizations. PBP models show promise in advancing Medicaid priorities, but are still in the early stages of development, and model design and implementation challenges remain. This article from the Center for Health Care Strategies explores the fundamentals of VBP and how PBP - a particular type of payment model - can help Medicaid agencies achieve goals related to care transformation and quality improvement, revenue stability, and controlling cost of care.
Hide- Authors: Anne Smithey, Kelsey Brykman
- Date: May 2023
- Competency: External Forces & Industry Knowledge
- Publication Name: In The Public Interest
- Topics: Health & Disability; Health & Disability>Health care quality; Health & Disability>Payment models; Health & Disability>Public financing - Health & Disability; Social Insurance; Social Insurance>Medicaid; Health & Disability>Provider risk