Blue Cross, BCN receive 4.5-Star Ratings from CMS

The Centers for Medicare & Medicaid Services recently announced its 2025 Medicare Star Ratings. Both our BCN Advantage℠ HMO plan and our Medicare Plus Blue℠ PPO plan earned a 4.5-Star rating. This strong performance places our plans among the highest-rated in the country.

Star Ratings are CMS’ measure of how well health plans serve Medicare Advantage members. They’re designed to evaluate how well plans that contract with Medicare perform, and to help consumers select a Medicare Advantage plan that works best for them.

“Star Ratings reflect how our Medicare Advantage members feel about the care and service they’ve received,” said Daniel J. Loepp, Blue Cross Blue Shield of Michigan president and CEO. “These 4.5-Star ratings wouldn’t be possible without the provider community’s commitment to delivering exceptional, high-quality care.”

The relationship between value-based care and Star Ratings

As Blue Cross and our provider partners have shifted from fee-based to value-based care models, HEDIS^® and Star quality performance has improved. Value-based care providers outperform their peers in key measures related to quality and cost, including better performance in rates of breast cancer and colorectal screenings and diabetic control measures.

“We’re committed to advancing value-based care to improve patient experience and health outcomes, goals directly tied to Star Ratings,” said Dr. James Grant, senior vice president and chief medical officer for Blue Cross Blue Shield of Michigan. “We are thankful for our clinical partners who have embraced value-based care and will continue to embrace models that focus on the patient and improving the health of our communities.”

The goal for the 2024 measurement year is to maintain 4+-Star Ratings for the PPO and HMO.

A deeper dive into the ratings

Medicare considers five categories when assigning Star Ratings:

• Maintaining health for members, including benefits such as cancer screenings and vaccines
• Managing chronic conditions, such as diabetes and blood pressure, including adherence to medications
• Customer service, including how responsive the plan is, as well as the quality of care that people with the plan receive
• Member complaint reports, which include problems in getting services and decisions on appeals
• Member experience with their plan, quality of care received and access to care

Blue Cross Blue Shield of Michigan’s 4.5-Star ratings for 2025 reflect sustained performance in several key areas, including HEDIS^® measures, medication adherence** and CAHPS^® surveys. The Consumer Assessment of Healthcare Providers and Systems surveys, developed by the Agency for Healthcare Research and Quality, evaluate a member’s experience with their plan, quality of care received and access to care.

**Medication adherence for management of several critical chronic diseases including diabetes, hypertension and hypercholesterolemia.

HEDIS^®, which stands for Healthcare Effectiveness and Information Set, is a registered trademark of the National Committee for Quality Assurance.

CAHPS^®, which stands for Consumer Assessment of Healthcare Providers and Systems, is a registered trademark of the Agency for Healthcare Quality and Research.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.