Your practice can earn an annual bonus when you achieve an Average Star Rating of 3.75 or higher.
| MA-PCPi Average Star Rating | Payment amount* |
|---|---|
| 4.75 and above | $125 PMPY |
| 4.50 - 4.74 | $80 PMPY |
| 4.00 - 4.49 | $40 PMPY |
| 3.75 - 3.99 | $20 PMPY |
| 3.74 and below | $0 |
| Measure Thresholds | |||||||
|---|---|---|---|---|---|---|---|
| 2023 Star ID |
Measure name | MA-PCPi weight | 1-Star | 2-Star | 3-Star | 4-Star | 5-Star |
| C01 | Breast cancer screening | 1 | <51% | 51% | 64% | 73% | 81% |
| C02 | Colorectal cancer screening | 1 | <56% | 56% | 66% | 74% | 81% |
| C09 | Eye exam for patients with diabetes | 1 | <50% | 50% | 64% | 73% | 82% |
| C11 | Hemoglobin A1c control for patients with diabetes | 3 | <56% | 56% | 70% | 80% | 88% |
| D08 | Medication adherence for diabetes medications | 3 | <81% | 81% | 85% | 88% | 92% |
| D09 | Medication adherence for hypertension (RAS antagonists) | 3 | <82% | 82% | 86% | 89% | 91% |
| D10 | Medication adherence for cholesterol (statins) | 3 | <81% | 81% | 85% | 89% | 92% |
| D12 | Statin use in persons with diabetes | 1 | <82% | 82% | 85% | 88% | 92% |
| C16 | Statin Therapy for Patients with Cardiovascular Disease | 1 | <79% | 79% | 83% | 86% | 90% |
| Patient experience performance percentages | |||||||
| NA | Getting needed care | 4 | NA | <88% | 88% | 92% | 95% |
| NA | Care coordination | 4 | NA | <84% | 84% | 88% | 93% |
| NA | Doctor patient conversations | 2 | NA | <52% | 52% | 58% | 66% |
| 2023 Star ID | Measure name | Measure performance percentage | Quality rating | MA-PCPi weight | MA-PCPi weighted quality rating |
|---|---|---|---|---|---|
| C01 | Breast cancer screening | 72% | 3 | 1 | 3 |
| C02 | Colorectal cancer screening | 84% | 5 | 1 | 5 |
| C09 | Eye exam for patients with diabetes | 77% | 4 | 1 | 4 |
| C11 | Hemoglobin A1c control for patients with diabetes7 | 75% | 3 | 3 | 9 |
| D08 | Medication adherence for diabetes medications | 91% | 4 | 3 | 12 |
| D09 | Medication adherence for hypertension (RAS antagonists) | 86% | 3 | 3 | 9 |
| D10 | Medication adherence for cholesterol (statins) | 89% | 4 | 3 | 12 |
| D12 | Statin use in persons with diabetes | 90% | 4 | 1 | 4 |
| C16 | Statin Therapy for Patients with Cardiovascular Disease | 88% | 4 | 1 | 4 |
| NA | Getting needed care | 96% | 5 | 4 | 20 |
| NA | Care coordination | 90% | 4 | 4 | 16 |
| NA | Doctor patient conversations | 59% | 4 | 2 | 8 |
| Total | 27 | 106 | |||
| In this example, the Average Star Rating for the 2023 program year would be 3.93 | |||||