HELEN News

October 2015

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CMS officials have publicly indicated that they intend to adjust the Medicare Advantage star rating system to account for the socioeconomic status (SES) of a plan’s beneficiaries.  Under the current ratings system, health plans serving largely low-income individuals have expressed concerns that they are unfairly penalized for the differential effort required to serve high proportions of low SES beneficiaries. According to a report by Modern Healthcare, acting CMS Administrator Andy Slavitt stated that CMS research “shows that there are statistically significant results for low-income and disabled beneficiaries in certain measures. We are now considering what...