Average Star Rating Improvement Bonus

This annual opportunity measures how much you moved the needle from last year’s results. Even if you didn’t meet the 3.75 minimum requirement needed to earn the Average Star Rating Bonus, you can earn a bonus for improved performance.

You can only receive one of these bonuses – Average Star Rating or Average Star Rating Improvement. The payment will be whichever of these two bonuses is greater.

Payment structure for Average Star Rating Improvement Bonus

MA-PCPi Average Star Rating Increase Payment amount*
1.50 - 4.00 $40 PMPY
1.00 - 1.49 $30 PMPY
0.50 - 0.99 $20 PMPY
*(PMPY = Per MA-PCPi customer per year)

Example calculation for Average Star Rating Improvement Bonus

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 diabetes 65% 2 3 6
D08 Medication adherence for diabetes medications 89% 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 90% 3 4 12
NA Care coordination 88% 4 4 16
NA Doctor patient conversations 59% 4 2 8
      Total 27 95
In this example, the Average Star Rating for the 2023 program year would be 3.52.

How to read the bonus calculation chart:

  • The table shows how an Average Star Rating Improvement Bonus payment would be calculated using numbers from a sample practice
  • The measure performance column shows the percentage of your patients who meet the numerator criteria for each measure (the patient experience measures are an exception to this criterion). The percentage determines the measure’s quality rating.
  • Each quality rating is multiplied by its MA-PCPi weight to determine the weighted quality rating
  • The sum of the weighted quality rating is 95. By dividing that total by the total sum of weights (27), the practice's Average Star Rating is 3.52.
  • The health care professional had a previous year Average Star Rating of 2.80
  • The difference between the current Average Star Rating and the previous Average Star Rating is 0.72
  • In this example, the practice would earn an improvement bonus of $20, per patient, per year