Star Rating System

CMS rates the relative quality of the private plans that are offered to beneficiaries through the Medicare Advantage program, on a one to five-star scale, with five stars representing the highest quality. The five-star quality scores for Medicare Advantage plans are derived from four sources: (1) CMS administrative data on plan quality and member satisfaction, (2) the Consumer Assessment of Healthcare Providers and Systems (CAHPS®), (3) the Healthcare Effectiveness Data and Information Set (HEDIS®), and (4) the Health Outcomes Survey (HOS). Under the Affordable Care Act, Under the Affordable Care Act, Medicare Advantage Plan payments are being adjusted based upon their Star Rating.