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Medicare AdvantageAdministrativeMedium impact

21-259m Medicare Star Ratings for 2021 and Beyond

Health Net·Pharmacy
Effective date
Jan 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Medicare is updating its Star Ratings system for 2021-2024 with increased emphasis on patient experience measures (quadrupled weight for CAHPS scores), new telehealth options for quality measures, and delayed data collection due to COVID-19. Several quality measures are being retired, moved to display status, or newly proposed.

Action Required

Action needed
Monitor quality measure documentation requirements for Medicare Advantage patients, especially patient experience metrics which now carry 4x weight in Star Ratings. Ensure telehealth visits (telephone, e-visits, virtual check-ins) are properly coded and documented for quality measures like diabetes care, blood pressure control, and cancer screenings. Review retired measures (Adult BMI Assessment, Rheumatoid Arthritis Management) to avoid unnecessary documentation burden.

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