Half the Score
The CY2027 Final Rule has fundamentally restructured the Medicare Star Ratings program, and positions community pharmacy to be the dominant driver of plan performance.
The CY2027 Final Rule removed 11 administrative measures, eliminating the operational safety net plans relied on. Pharmacy-influenced measures will now account for approximately 50% of a Medicare Advantage plan's Overall Star Rating.
The five triple-weighted measures (Medication Adherence for Diabetes, Hypertension, and Cholesterol; Controlling Blood Pressure; Blood Sugar Controlled) alone represent 43% of total CY2029 weight. All five are directly addressable through pharmacy-led intervention.
Medicare beneficiaries visit community pharmacies nearly twice as often as primary care physicians. With 90% of Americans within five miles of a pharmacy and 85% rating pharmacists as the most accessible healthcare provider, plans have an underutilized quality partner already embedded in their networks.
EQUIPP® converts that access into measurable performance. Through real-time member-level gap identification, structured longitudinal outreach for adherence, and NCQA-validated HEDIS supplemental data submission, EQUIPP® transforms pharmacy from a passive dispensing channel into an accountable, documented care team member, directly moving the measures that now define plan success.
Half the Score
The CY2027 Final Rule has fundamentally restructured the Medicare Star Ratings program, and positions community pharmacy to be the dominant driver of plan performance.
The CY2027 Final Rule removed 11 administrative measures, eliminating the operational safety net plans relied on. Pharmacy-influenced measures will now account for approximately 50% of a Medicare Advantage plan's Overall Star Rating.
The five triple-weighted measures (Medication Adherence for Diabetes, Hypertension, and Cholesterol; Controlling Blood Pressure; Blood Sugar Controlled) alone represent 43% of total CY2029 weight. All five are directly addressable through pharmacy-led intervention.
Medicare beneficiaries visit community pharmacies nearly twice as often as primary care physicians. With 90% of Americans within five miles of a pharmacy and 85% rating pharmacists as the most accessible healthcare provider, plans have an underutilized quality partner already embedded in their networks.
EQUIPP® converts that access into measurable performance. Through real-time member-level gap identification, structured longitudinal outreach for adherence, and NCQA-validated HEDIS supplemental data submission, EQUIPP® transforms pharmacy from a passive dispensing channel into an accountable, documented care team member, directly moving the measures that now define plan success.
Half the Score
The CY2027 Final Rule has fundamentally restructured the Medicare Star Ratings program, and positions community pharmacy to be the dominant driver of plan performance.
The CY2027 Final Rule removed 11 administrative measures, eliminating the operational safety net plans relied on. Pharmacy-influenced measures will now account for approximately 50% of a Medicare Advantage plan's Overall Star Rating.
The five triple-weighted measures (Medication Adherence for Diabetes, Hypertension, and Cholesterol; Controlling Blood Pressure; Blood Sugar Controlled) alone represent 43% of total CY2029 weight. All five are directly addressable through pharmacy-led intervention.
Medicare beneficiaries visit community pharmacies nearly twice as often as primary care physicians. With 90% of Americans within five miles of a pharmacy and 85% rating pharmacists as the most accessible healthcare provider, plans have an underutilized quality partner already embedded in their networks.
EQUIPP® converts that access into measurable performance. Through real-time member-level gap identification, structured longitudinal outreach for adherence, and NCQA-validated HEDIS supplemental data submission, EQUIPP® transforms pharmacy from a passive dispensing channel into an accountable, documented care team member, directly moving the measures that now define plan success.
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