Dive Brief:
- The CMS recently released its intent to develop a star-rating system specifically for health plans established under the Financial Alignment Initiative, which aims to improve the experience for dual Medicare-Medicaid enrollees and align the financial incentives of the programs.
- The announcement came out in a notice this month to those plans participating in the state-administered demonstrations, Modern Healthcare reports.
- The notice details how the agency plans to structure the rating system and what measures would be factored into the ratings.
Dive Insight:
When, or even whether, the ratings will be created remains undetermined.
"...We intend to start work now to prepare for potential future expansion of the capitated financial alignment model," the notice states. "We are not proposing to expand the capitated financial alignment model at this time." The CMS goes on to say the decision on whether to expand the model will hinge on whether findings about the initiative meet the statutory criteria for expansion.
However, the ratings would only be created if the CMS decides to expand the initiative, and that will only happen if the demonstrations actually improve the quality of care for beneficiaries and save money.
Given that could take years, CMS says it intends in the meantime to post quality performance data beginnning in 2016 on the Medicare-Medicaid Coordination Office website.
The CMS is soliciting comments on the proposal until Dec. 21.