With Addition of HEI to Stars, Clock Is Ticking for MAOs to Advance Health Equity

So as not to penalize Medicare Advantage plans serving a large proportion of enrollees with social risk factors (SRFs) that impact care quality, CMS has previously taken steps to adjust for within-contract disparities in Star Ratings performance among MA and Part D contracts. But beginning in 2027, insurers will be rewarded for their efforts to assess SRFs and address disparities in certain quality measures with the new health equity index (HEI). MA and Part D organizations must act now to assess disparities within their contracts’ current performance and begin to pinpoint where their efforts can make the biggest impact in the two years of data leading up to the reward, according to industry experts who spoke at AHIP’s 2023 conference.

© 2024 MMIT
Lauren Flynn Kelly

Lauren Flynn Kelly Managing Editor, Radar on Medicare Advantage

Lauren has been covering health business issues since the early 2000s and specializes in in-depth reporting on Medicare Advantage, managed Medicaid and Medicare Part D. She also possesses a deep understanding of the complex world of pharmacy benefit management, having written AIS Health’s Radar on Drug Benefits from 2004 to 2005 and again from 2011 to 2016. In addition to her role as managing editor of Radar on Medicare Advantage, she oversees AIS Health’s publications and manages the health editorial staff. She graduated from Vassar College with a B.A. in English.

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