CMS Quality Star Ratings Program

The Centers for Medicare & Medicaid Services evaluates health insurance plans and issues star ratings each year; these ratings may change from year to year. The star rating system uses quality measurements that are widely recognized within the health care and health insurance industry to provide an objective method for evaluating health plan quality.

The overall plan rating combines scores for the types of services Blue Cross Blue Shield of Michigan offers. CMS compiles its overall score for quality of services based on over 50 different Medicare Part C and Part D measures, and uses information from many different sources to compile its overall star rating for BCBSM. Some of these sources include member surveys administered by Medicare-approved vendors, information from doctors, information we report to CMS and results from Medicare's regular monitoring activities.

BCBSM works with providers and members to make sure members received appropriate and timely care, that chronic conditions are well managed, that members are pleased with the level of service from their health plan and care providers, and that health plans follow CMS operational and marketing requirements.

BCBSM’s new Medicare Advantage tool, Health e-Blue℠ helps physicians identify gaps in care and receive information about their patients through enhanced encounter facilitation. Health e-Blue is designed to enable providers to get the information they need on how many and which patients haven’t had certain needed services (such as mammograms) and enable them to take action toward providing those services.

Find more information about BCBSM’s new Medicare Advantage tool, Health e-Blue℠.

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