From a published Star Rating to the fix worth doing first

One illustrative plan, the same figures as our homepage.

1
A typical plan: 3.5★, 15,000 members.
Rated 3.5★, one step below 4.0★, where the Quality Bonus Payment begins. The figures are typical of 3.5★ plans.
2
Do nothing, and 2029 costs about $9.2M a year.
CMS has finalized measure changes for the 2029 Star Ratings. With no improvement, this plan slips from 3.5★ to 3.0★.
−$9.2M
a year, modeled
3
Three measures share one cause.
Medication adherence for diabetes, blood pressure and cholesterol all sit at 2★. Each is triple-weighted, and all three trace to one capability: chronic condition medication management.
4
The same fix holds 3.5★ and reaches 4.0★: about $9.0M more a year.
Closing the adherence gap with the pharmacy partner moves all three measures together. It holds 3.5★ through the 2029 changes and reaches 4.0★.
+$9.0M
a year, modeled
5
About $18M a year at stake.
QPROi names the fixes in order, with the owner and the value of each, from public CMS data, before a plan shares anything.
$18M
a year, modeled

Illustrative. CMS payment rules at the median benchmark, bid and risk score of 3.5★ plans. Dollar values are modeled from public CMS files.

A typical plan: 3.5★, 15,000 members.