2023 Blue Medicare Advantage Stars Incentive Program

As a valued Blue Medicare Advantage (MA) provider with Blue Cross and Blue Shield of Kansas (BCBSKS), we recognize your daily contributions providing and coordinating quality care to our fellow Kansans and BCBSKS looks to reward your efforts accordingly through our 2023 Blue Medicare Advantage Stars Incentive Program.

2023 Measures and Incentives

• New for 2023:
  • $300 – Annual Wellness Visit
  • $50 – Uncontrolled Blood Pressure
• Returning for 2023:
  • $100 – Breast Cancer Screening
  • $100 – Colorectal Cancer Screening
  • $200 – Controlling Blood Pressure
  • $100 – Eye Exam for Patients with Diabetes
  • $100 – Hemoglobin A1c Control for Patients with Diabetes
  • $50 – Medication Adherence – Cholesterol*
  • $50 – Medication Adherence – Diabetes*
  • $50 – Medication Adherence – Hypertension*
  • $100 – Statin Therapy Cardiovascular Disease
  • $100 – Statin Use in Persons with Diabetes
  • $100 – Transitions of Care – Medication Reconciliation
  • $100 – Transitions of Care – Patient Engagement

*Returning measure, newly incentivized for 2023

Our 2023 incentives recognize the impact of our participating MA primary care providers in achieving the objectives of the National Committee for Quality Assurance (NCQA) and Centers for Medicare & Medicaid Services (CMS) Star Ratings Program, and further acknowledges the time spent by clinics outside of face-to-face provider encounters, through outreach, referral, care coordination, administration, and much more.

The incentives above are a fixed dollar amount per star gap closed by the end of the year, based upon patient attribution as of December 2023. Incentive and measures will begin reporting on 2023 Member-Level Detail Reports and Scorecards, with distribution beginning in early July 2023. For details and assistance in capturing incentives and closing gaps in care, refer to our Understanding Stars Ratings manual, soon to be updated for 2023, at www.bcbsks.com/providers/medicare-advantage.

Annual Wellness Visit (AWV)

New for 2023, the AWV measure incentivizes wellness exams for your attributed patients, recognizing the importance of these preventive visits in achieving and coordinating quality care. Providers capture this incentive by rendering and billing the appropriate Medicare wellness exam, or Welcome to Medicare exam, procedure code. For additional information on these codes, and details on enhanced Blue MA coverage, review the Annual Physical Exam Policy on the MA provider section of our website.

Uncontrolled Blood Pressure (UCB)

Also debuting in our 2023 MA incentive program, the Uncontrolled Blood Pressure (UCB) measure incentivizes usage of CPT®II codes reporting diastolic and systolic blood pressures on claim submissions. Including these procedure codes on claims are key to closing gaps for the Controlling Blood Pressure (CBP) HEDIS® measure, quickly becoming industry best practice. While we also incentivize gap closure for the CBP measure, we recognize the potential administrative lift submitting these HCPCS codes may present to your practitioners, billing staff, and IT teams and wish to help ease any financial barriers to implementation with the new measure.

Important Dates

• May/June 2023 – Final 2022 Scorecards and Member-Level Detail Reports
• June 15, 2023 – Payout for 2022 MA Stars Incentive Program
• Early July 2023 through March 2024 – Monthly Scorecards and Member-Level Detail Reports delivered by email.
• December 15, 2023 – Deadline to submit supplemental data for gap closure
• February 28, 2024 – Deadline to submit claims for gap closure
• Q2 2024 – Payout for 2023 MA Stars Incentive Program

Questions?

If you have questions regarding this publication, please contact your Medicare Advantage Professional Relations Representative, Patrick Artzer, or visit the MA Provider section of our website.