Medicare’s Star Rating System for Private Plans Is under scrutiny

The quality rating system employed to award the bonuses is highly being criticized as the federal government puts billions of bonus dollars into private Medicare health plans to promote better care. Critics comprising the Government Accountability Office and the Medicare Payment Advisory Commission, question whether the $8 billion-plus program is generally rewarding mediocre patient quality.

The recent attack was in the form of a report last week from the American Action Forum, a conservative think tank, which held that some standards are hard to measure and that it’s tough to score well when plans don’t always know the criteria in advance.Supporters defend the program as part of a broad proposal to improve the quality of patient care and point to provable enhancement.  For example, a San Diego physicians group that exposed 700 Medicare insurance patients with diabetes who were not receiving annual eye exams, despite the fact that failure to get early treatment may lead to blindness.

The federal government initiated the star rating system in 2007 as a guide to help seniors evaluate the quality of private health plans in the Medicare Advantage program.

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