Each year, the Centers for Medicare and Medicaid Services (CMS) publish quality ratings for Medicare Part C and D plans. Plans are given a rating between 1 and 5 stars, with Quality Bonus Payments (QBPs) going to plans earning 4 or 5 stars. According to one study, these QBPs can amount to an extra 5% per member annually.
Star assignments are based on a formula examining a series of indicators, including the Accuracy and Accessibility Study. CMS conducts the study between February and June by placing calls to prospective enrollee-beneficiary call centers to evaluate performance in assisting Limited English Proficient (LEP) callers. The study measures the availability of an interpreter, as well as the accuracy of information provided. Most plans strive to earn a grade of 90% or above to obtain a 4- or 5-star rating.
Our new guide to the 2019 CMS Call Center Monitoring Study will help you: