In this section, you’ll find:
• How we work with providers
• Reporting options
• Changes to Star ratings
We have teams focused on driving five-star quality outcomes for you and your patients. Here are some highlights of the work our teams do for you on a daily basis:
Stars reporting often uses measure abbreviations that can be found here.
Cigna Healthcare provides reporting with patient-level information around open gaps in care. This information is intended to help you provide the best possible care and achieve the highest possible Star rating. Please use the list below to see the full suite of reporting resources available through your Provider Performance Enablement team:
Additional market-specific reports may also be available through your Provider Performance Enablement representative. Examples of some reports are:
CMS updates its Five-Star Quality Rating System annually to include new measures, update existing measures, retire measures, and display measures that may be included in future Star ratings. Here are some examples of recent changes to the Star measures and some potential changes in the near future:.
HEDIS measures
Pharmacy Part D (PDE)
CAHPS
The following CAHPS measures moved from 2x to 4x weighted starting with the 2023 Star Rating:
HOS
HOS measures around Improving and Maintaining Mental and Physical Health, formerly 3x weighted, were removed from the Star Rating and placed on display for 2022 and 2023 Star Ratings. These measures are expected to return as 1x weighted measures for 2025 Star Rating and 3x weighted measure for 2026 Star Rating.
Administrative measures
The following Administrative measures were moved from 2x weighted to 4x weighted for starting with the 2023 Star Rating: