| Health equity index | CMS confirmed the HEI will be introduced, replacing the current reward factor in star year 2027 | Not modeled | |
|---|---|---|---|
| Measure re-weighting | Reduction of the weight of patient experience/complaints and access measures from 4 to 2 beginning in star year 2026 |  | |
| Measure changes | Measure additions/retirements from prior rulemaking The following measure additions were finalized prior to the calendar year 2024 rulemaking process for star ratings year 2024 and beyond:
| | |
| Measure additions/retirements from CMS’s april final rule Retirement of the diabetes care — kidney disease monitoring measure and addition of the kidney health evaluation for patients with diabetes measure for star year 2026 | | | |
| Pending proposed measure additions/retirements The following measure additions will be addressed in later rulemaking, star year 2027 at the earliest:
|  | | |
| Extreme and uncontrollable circumstances | CMS eliminated the 60% rule used when creating measure cut points for star year 2026 | Not modeled — minimal impact expected | |
| Improvement measure modification | CMS proposed modifying the improvement measure hold harmless provision to apply to only contracts with 5 stars. Pending additional rulemaking, impacts Star Year 2027 at the earliest | | |
| Measure cut point guardrails | CMS proposed removing the bidirectional caps that restrict the maximum allowable movement of measure cut points. Pending additional rulemaking, impacts star year 2027 at the earliest | Not modeled — minimal impact expected | |
| Other measure changes | CMS changed various measure methodology, such as inclusion of risk adjustment for medication adherence | Not modeled — minimal impact expected | |
