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Dr Snezana Mahon on Star Rating Impacts
How a health plan performs in the CMS star ratings to going to have a bigger impact on their finances in the coming years, Snezana Mahon, PharmD, senior director of Medicare solutions at Express Scripts, said.
How a health plan performs in the CMS star ratings to going to have a bigger impact on their finances in the coming years, Snezana Mahon, PharmD, senior director of Medicare solutions at Express Scripts, said at the America’s Health Insurance Plans’ National Conferences on Medicare and Medicaid, and Dual Eligibles Summit in Washington, DC.
Next year, plans that receive 3.5 stars or less will no longer receive the quality bonus payment, she said.
“So only 4 and 5 star performing plans will be able to receive the quality bonus payments,” Dr Mahon said. "3.5 star plans will now be going down to a 0% bonus payment."
ACA Network Regulatory Filings Are Inaccurate, Poorly Match Provider Directories
September 16th 2025A secret shopper survey (N = 8306) in Pennsylvania’s Affordable Care Act (ACA) Marketplace found inconsistencies between carrier regulatory filings and provider directories, frequent inaccuracies in regulatory filings, and challenges in securing timely appointments.
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