Medicare and the Star Ratings Program | What is Health and Fitness ...

In 2008 The Centers for Medicare and Medicaid or (CMS) introduced a new program to aid families in the selection of nursing homes for loved ones. The program is the Medicare Star Ratings Program. The families now have a chance to compare nursing homes based on a number of different important areas.

Nursing homes are given a rating between one star and five stars, with five being the highest quality and one being considered a failing grade. When nursing homes are graded these ratings take a number of different factors into consideration. The three main factors that are looked at when the ratings are assigned include nursing home health inspections, the ratio between patients and staff, as well as other self-reported measures of quality. However, there are many nursing home administrators who believe these measures do not show the full capability or quality of a nursing home.

There are a number of people who believe that there are flaws within the current Medicare Five Star Rating Program. While they do a good job at measuring the hard evidence as seen in health inspections, they fail to look past the numbers and at the overall happiness of the patients and their families. Some administrators believe that there should be additional factors taken into consideration when grading nursing homes including family and patient satisfaction. Currently there is no way to grade how well the staff interacts or cares about their patients, something that many find to be an important factor when choosing a nursing home.

Another flaw that many believe to be found within the rating system is that it is restricted by state lines. With a bell curve in effect for the fixed quotas that need to be reached, each state has to have at least 10% of its nursing homes in the lowest rating, and 20% in the highest. However, because it is restricted by state lines it means that a nursing home in one state with a 1 star rating could be providing higher quality care than the nursing home with 2 star rating in another state. The government is working on updating the five star rating program and the changes should be announced sometime in the spring of 2012.

Altrega Health?s Quality Performance Solutions help maximize ratings and reimbursement from Medicare and Medicaid as the (CMS) uses a star rating program to determine the level of reimbursement that Medicare Advantage Plans receive.

Click here to find out more about Medicare.

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