CMS to Pay Bonuses to Medicare Advantage Plans Based on Quality of Outcomes

Still No Medicare Quality Measures for Clinical Laboratories and Pathology Groups

Transparency in provider outcomes is moving one step forward and this time it’s a new bonus plan for Medicare Advantage plans. The Centers for Medicare and Medicaid Services (CMS) believes the enhancement will encourage lower performing plans to improve their quality of care.

Quality Measures Should Interest Medical Laboratory Managers

Pathologists and clinical laboratory managers will be interested to learn that, during the 3-year demonstration project, bonuses of 5% will be paid to Medicare Advantage plans that achieve a 5-star rating. Lesser bonuses will be paid to those plans that achieve three to four stars. A new twist is that this update also includes a new “low performer” icon to alert Medicare Advantage recipients of plans that earn less than three stars over a 3-year period.