Quality Measures

Elevance sues CMS after Medicare Advantage stars recalculation

Regulators recalculated plans’ quality scores last month after losing a lawsuit to Clover Health. But they used a different methodology for Clover than its peers, causing Elevance to lose out on $115 ...

Medicare Will Spend More Than $13 Billion on the Medicare Advantage Quality Bonus Program in 2026

The Medicare program will spend at least $13 billion on the Medicare Advantage quality bonus program in 2026, as 68% of Medicare Advantage enrollees are in a plan that qualifies for higher payments un...

Post-Clover and 2027 QBP Re-Calculation: What Could Be Next for MA Stars?

Overwhelmed ACOs: House aims to simplify quality reporting requirements

Overwhelmed ACOs: House aims to simplify quality reporting requirements  Medical Economics

Overwhelmed ACOs: House aims to simplify quality reporting requirements

Medicare Advantage bonuses will exceed $13B this year, KFF finds

Medicare is spending more on quality bonuses despite fewer enrollees in eligible plans, the health policy research group said — a concerning trend putting more stress on Medicare’s coffers that could ...

Rethinking Coding and Documentation in a Value-Based Care Environment

How to Embed Person-Centered Outcomes Into Your Quality Strategy

How to Embed Person-Centered Outcomes Into Your Quality Strategy  NCQA

new KFF analysis

From newsletter: Spending on Medicare Advantage Quality Bonus Program Will Total $13.4 billion in 2026 Federal Spending on the Medicare Advantage Quality Bonus Program Will Total $13.4 billion in 20...

Avoiding Payment Penalties and Maximizing Reimbursement: The Revenue Strategy Health Systems Can’t Afford to Miss

Hospitals are under growing pressure as payment programs shift toward value-based models that leave less room for error. The organizations that stand to benefit most are those that recognize a broader...