Certified Risk Adjustment Coder (CRC)

What does CMS' Star Ratings program monitor?

1. Performance of Medicare Advantage plans

2. Fraud and abuse

3. Adherence to state scope of practice

4. Performance of Medicare providers

The correct answer is: Performance of Medicare Advantage plans

The Star Ratings program from the Centers for Medicare & Medicaid Services (CMS) specifically monitors the performance of Medicare Advantage plans. This program utilizes a range of quality metrics to assess how well these plans provide care to their enrollees and how efficiently they manage health outcomes. The ratings are based on various factors, including patient satisfaction, quality of care, and health outcomes, allowing both consumers and providers to make informed choices regarding healthcare options. The program aims to encourage continuous improvement in quality by providing public performance data, which is critical for beneficiaries in selecting plans that best meet their healthcare needs. High Star Ratings can also lead to financial incentives for the plans, reinforcing their commitment to quality improvement and positive patient experiences.