Future Measure changes

 

 

Measurement Year 2024 (Star year 2026) Stars Changes

Program changes

• Health Equity Index capture starts;Last year for RF¹

Weight Changes

• CAHPS & Admin measures to 2x (Patients’ Experience and Complaints Measure)²

New Measures

• Improving/Maintaining Physical Health (1x)³
• Improving/Maintaining Mental Health (1x)³  
• Kidney Health for Patients with Diabetes (1x)¹

 

Measurement Year 2025 (Star year 2027) Stars Changes

Program changes

• (Proposed) - CMS has proposed to rollback this change¹⁰
• Health Equity Index introduced; RF replaced

Weight Changes

• Improving/Maintaining Physical Health increases to 3x³
• Improving/Maintaining Mental Health increases to 3x³

New Measures

• Care for Older Adults—Functional Status Assessment (1x)⁴
• Concurrent Use of Opioids and Benzodiazepines (COB) (1x)⁵
• Polypharmacy Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) (1x)⁵

Retired Measures

• Care for Older Adults – Pain Assessment⁸
• Medication Reconciliation Post-discharge (MRP)⁶
• MTM Program Completion Rate for Comprehensive Medication Review (CMR) – Retired to display⁷  

 

Measurement Year 2026 (Star year 2028) Stars Changes

Weight Changes

• Implementation of the SDS risk adjustment to the three medication adherence measures - Weight reduced to 1x in MY 26.  Back to 3x in MY27⁹
• Medication Adherence for Diabetes Medication
• Medication Adherence for Hypertension (RAS Antagonists)
• Medication Adherence for Cholesterol (Statins)
• Nonsubstantiative updates - Remove Medication Adherence adjustments for stays in inpatient facilities (IP) and skilled nursing facilities (SNFs)

 

Retired Measures¹⁰

• (Proposed) Part C&D Call Center – Foreign Language Interpreter and TTY Availability
• (Proposed) Statin Therapy for Patients with Cardiovascular Disease

 

 

Measurement Year 2027 (Star year 2029) Stars Changes

Weight Changes

• Three medication adherence (Weight back to 3x)⁹

New Measure (Proposed)¹⁰

• Depression Screening and Follow-Up

Retired Measures (Proposed)¹⁰

• Plan Makes Timely Decisions about Appeals
• Reviewing Appeals Decisions
• Special Needs Plan (SNP) Care Management
• Complaints about the Health/Drug Plan
• Medicare Plan Finder Price Accuracy
• Diabetes Care – Eye Exam
• Members Choosing to Leave the Plan
• Customer Service
• Rating of Health Care Quality

Source:

1 - https://www.federalregister.gov/d/2023-07115/p-24

2 - https://www.federalregister.gov/d/2023-07115/p-1574

3 - https://www.federalregister.gov/d/2021-00538/p-690

4 - https://www.federalregister.gov/d/2024-07105/p-1860

5 - https://www.federalregister.gov/d/2024-07105/p-1920

6 - https://www.federalregister.gov/d/2024-07105/p-1833

7 - https://www.federalregister.gov/d/2024-07105/p-1877

8 - https://www.cms.gov/files/document/2025-advance-notice.pdf

9 - https://www.federalregister.gov/d/2023-07115/p-1505

10 - 2025-21456.pdf