Learning Group: Quality

The Quality Learning Group participants collaborate to share best practices and learn quality improvement strategies from one another. ACHP quality leaders have discussed measures such as NCQA and CMS Star Ratings, strategies for provider and consumer engagement, accreditation by quality organizations and other issues that impact consumer experience. The group also works closely with important stakeholders—such as NCQA—to ensure ACHP plans remain an influential voice in the quality arena.

CMS MA Star Ratings Working Group

The CMS MA Star Ratings Working Group is comprised of member plan experts in Medicare Advantage policies and payment models. The group works to develop tools and resources for member plans to assess and improve Star Rating performance and also provides feedback and suggestions to shape policy recommendations and responses to CMS rule changes.  To join this working group, please contact Christa Fields at cfields@achp.org.


2017 Quality Focus Meeting — May 2017 (San Diego, CA)
2016 Quality Focus Meeting — February 2016 (Miami, FL)

Webinars and Virtual Learning

Webinar: Understanding the 2017 CMS MA Star Ratings — November 2017
Star Ratings Measures & Weights: 2017 — October 2017
Star Ratings Summary Data – All Plans (Sortable) — October 2017
Star Ratings Cut-Point Changes: 2016-2017 — October 2017
National Distributions for Star Ratings Measures — October 2017
Star Ratings by Contract and State — October 2017
National Percentiles for Medicare Measures — October 2017
Respiratory Health Measure Performance — January 2016
Pharmacy Quality Alliance Measurement Update — July 2016
ACHP-NCQA Senior Leadership Discussion — September 2016
CMS MA Star Ratings Performance — June 2016 


Understanding the 2017 NCQA Health Plan Ratings2016 NCQA Ratings Measures by Line of Business

2016 NCQA Commercial Ratings – Measure Distributions & Cut-Points

HealthPlan Performance Gauge® — 2017 Release 
An interactive Microsoft Access database that is one of ACHP’s premiere quality analytic tools. It gives ACHP members the ability to benchmark clinical, customer satisfaction and utilization performance in their commercial, Medicare and Medicaid businesses.

Access the 2017 ACHP HPPG® Release Presentation slide deck, or view the demonstration recording. 

Quality Management Systems Inventory — 2015 Release 
ACHP has developed an inventory among its member plans relating to their quality management systems, capabilities and vendor relationships to enable networking and sharing of experiences. The information is divided into various categories: Claims System (provided for context), HEDIS Collection and Reporting, NCQA Accreditation, Medical Record Review Validations, Credentialing Verification, Surveys, Disease Management, Analytic Software, and Quality Management Activities.