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December 2022

Blue Cross and BCN receive high Medicare Star Ratings from CMS again this year

You may have seen this article previously in Hospital and Physician Update but we’re reprinting it here in case you missed it. To subscribe to the Update or any of our other provider publications, click here.

The Centers for Medicare & Medicaid Services recently announced its 2023 Medicare Star Ratings — and Blue Cross Blue Shield of Michigan achieved strong results.

Both our BCN Advantage℠ HMO plan and our Medicare Plus Blue℠ PPO plan captured 4.5-Star ratings, making our plans once again among the highest-rated in the country.

CMS publishes Star Ratings each year to measure the quality of health services received by beneficiaries enrolled in Medicare Advantage plans. They’re designed to evaluate how well plans that contract with Medicare perform, and to help consumers select a Medicare Advantage plan that works best for them.

“These phenomenal ratings reflect our dedication to provide our Medicare members with service that goes above and beyond,” said Daniel J. Loepp, Blue Cross president and CEO. “We are grateful to the care teams in our network who work closely with our members to meet their health care needs.” 

Medicare considers five categories when assigning Star Ratings:

  • How the plan emphasizes staying healthy, including such benefits as screenings, tests and vaccines
  • How the plan manages chronic conditions
  • How responsive the plan is, as well as the quality of care that people with the plan receive
  • Member complaint reports, which include problems in getting services and decisions on appeals
  • How many members leave the plan each year

Blue Cross Blue Shield of Michigan’s high ratings for 2023 reflect sustained performance in several key areas, including HEDIS® measures** and CAHPS® surveys.*** The Consumer Assessment of Healthcare Providers and Systems surveys, developed by the Agency for Healthcare Research and Quality, evaluate a member’s experience with their plan, quality of care received and access to care.

The role of health care providers

Dr. James Grant, senior vice president and chief medical officer for Blue Cross, acknowledged the important role health care providers played in achieving the ratings. “We couldn’t have achieved this strong performance without our physician partners and the efforts of each patient care team. These professionals interact with our patients every day and are helping to provide quality care to everyone they touch,” he said.  

Going forward, Blue Cross and BCN will continue to work with health care providers to focus on quality, pursue operational excellence and provide a best-in-class experience for our members.

**HEDIS®, which stands for Healthcare Effectiveness and Information Set, is a registered trademark of the National Committee for Quality Assurance.

***CAHPS®, which stands for Consumer Assessment of Healthcare Providers and Systems, is a registered trademark of the Agency for Healthcare Quality and Research.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2021 American Medical Association. All rights reserved.