Medicare Stars

Alameda Alliance Wellness values our dedicated provider partners and is committed to supporting high-quality, coordinated care for our shared D-SNP members. This resource hub provides quick access to Stars measure tip sheets, best practice guides, and workflow tools to help your clinical teams document accurately, close care gaps efficiently, and improve performance.

Why Stars Measures Matter

• Improves timely and preventive care for our shared D-SNP members.
• Ensures documentation and coding reflect the care provided.
• Supports performance-based reimbursement and quality outcomes.

Medicare Stars Program Resources

Medicare Stars Guide

A measure-specific reference designed to support providers and clinics in improving Stars performance. This guide offers detailed insights into each measure, including best practices, coding tips, and workflow strategies.

Alameda Alliance Wellness Medicare Star Rating

Each year, Medicare evaluates plans based on a 5-star rating system. These ratings help members compare plans based on quality and performance.

Measure Tip Sheets (Coming soon)

• Breast Cancer Screening (BCS-E)
• Care for Older Adults (COA)
• Colorectal Cancer Screening (COL-E)
• Concurrent Use of Opioids and Benzodiazepines (COB)
• Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Survey (HOS)
• Controlling Blood Pressure (CBP)
• Eye Exam for Patients with Diabetes (EED)
• Glycemic Status Assessment for Patients with Diabetes (GSD)
• Initial Preventive Physical Exam (IPPE) and Annual Wellness Visit (AWV)
• Kidney Health Evaluation (KED)
• Medication Adherence
• Osteoporosis Management in Women Who Had a Fracture (OMW)
• Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (POLY-ACH)
• Statin Therapy for Patients with Cardiovascular Disease (SPC-E)
• Statin Use in Persons with Diabetes (SUPD)

Medicare Risk Adjustment

Risk Adjustment is a CMS program that helps ensure health plans have the appropriate resources to care for members with different health needs. It uses the diagnoses documented by providers to understand a member’s health status and adjust plan payments accordingly. Risk adjustment does not affect a member’s premium or benefits.

• Risk Adjustment Coding Best Practices

Additional Resources

• Billing Staff Reference Guide (Coming soon)
• Provider Reference Guide (Coming soon)

For support or technical assistance, please contact the Alliance Stars Team at DeptStarsTeam@alamedaalliance.org.