Understanding the CMS Star Ratings - Staying Healthy: Screenings, Tests and Vaccines HD1
Does the plan do a good job detecting and preventing illness? This category addresses how well each plan works to detect and prevent illness, and improve or maintain the physical and mental health of its members. For example, it may include whether plan members get regular screenings for certain types of cancer or conditions and whether plan members get certain vaccines.This category is based on seven (7) sub-categories:
The staying healthy: screenings, tests and vaccines data comes from two sources: A survey of Medicare health plan enrollees (the Health Outcomes Survey). Clinical quality data collected from Medicare health plans. The results have been independently validated.
Additional data source information for each sub-category is outlined below.
Breast Cancer Screening
Percent of female plan members aged 52-74 who had a mammogram during the past 2 years.Data Source:
This information is from clinical quality data collected from Medicare health plans. The results have been independently validated.
Colorectal Cancer Screening
Percent of plan members aged 50-75 who had appropriate screening for colon cancer.Data Source:
This information is from clinical quality data collected from Medicare health plans. The results have been independently validated.
Annual Flu Vaccine
Percent of plan members who got a vaccine (flu shot) prior to flu season.Data Source:
This information is from a survey conducted with Medicare Health Plan enrollees.
Improving or Maintaining Physical Health
Percent of all plan members whose physical health was the same or better than expected after two years.Data Source:
This information is from the Health Outcomes Survey conducted with Medicare Health Plan enrollees.
Improving or Maintaining Mental Health
Percent of all plan members whose mental health was the same or better than expected after two years.Data Source:
This information is from the Health Outcomes Survey conducted with Medicare Health Plan enrollees.
Monitoring Physical Activity
Percent of senior plan members who discussed exercise with their doctor and were advised to start, increase or maintain their physical activity during the year.Data Source:
This information is from the Health Outcomes Survey conducted with Medicare Health Plan enrollees.
Checking to See if Members Are at a Healthy Weight
Adult BMI assessment. Percent of plan members with an outpatient visit who had their "Body Mass Index" (BMI) calculated from their height and weight and recorded in their medical records.Data Source:
This information is from clinical quality data collected from Medicare health plans. The results have been independently validated.