How do I compare the quality of health care providers?

Medicare collects information about the quality and safety of medical care and
services given by most health care providers (and facilities).
Visit Medicare.gov/quality-care-finder and use the Compare tools to get a
snapshot of the quality of care health care providers (and facilities) give their
patients. Some of these tools feature a star rating system to help you compare
quality measures that are important to you. Find out more about the quality of
care by:
• Asking what your health care provider does to ensure and improve the quality
of care. Each health care provider should have someone you can talk to about
quality.
• Asking your doctor or other health care provider what he or she thinks about
the quality of care other providers give. You can also ask your doctor or other
health care provider about the quality of care information you find on the
Medicare.gov Compare tools

How do I compare the quality of Medicare health and
drug plans?
The Medicare Plan Finder at Medicare.gov/find-a-plan features a star rating
system for Medicare health and drug plans. The Overall Star Rating gives an
overall rating of the plan’s quality and performance for the types of services
each plan offers.
For plans covering health services, this is an overall rating for the quality of
many medical/health care services that fall into 5 categories:

  1. Staying healthy—screening tests and vaccines: Includes whether members
    got various screening tests, vaccines, and other check-ups to help them stay
    healthy.
  2. Managing chronic (long-term) conditions: Includes how often members with
    certain conditions got recommended tests and treatments to help manage
    their condition.
  3. Member experience with the health plan: Includes member ratings of the
    plan.
  4. Member complaints and changes in the health plan’s performance: Includes
    how often Medicare found problems with the plan and how often members
    had problems with the plan. Includes how much the plan’s performance has
    improved (if at all) over time.
  5. Health plan customer service: Includes how well the plan handles member
    appeals.

For plans covering drug services, this is an overall rating for the quality of
prescription-related services that fall into 4 categories:

  1. Drug plan customer service: Includes how well the plan handles member
    appeals.
  2. Member complaints and changes in the drug plan’s performance:
    Includes how often Medicare found problems with the plan and how
    often members had problems with the plan. Includes how much the plan’s
    performance has improved (if at all) over time.
  3. Member experience with plan’s drug services: Includes member ratings of
    the plan.
  4. Drug safety and accuracy of drug pricing: Includes how accurate the
    plan’s pricing information is and how often members with certain medical
    conditions are prescribed drugs in a way that’s safer and clinically
    recommended for their condition.
    For plans covering both health and drug services, the overall rating for
    quality and performance covers all of the topics above.
    You can compare the quality of care and services given by health care
    providers and Medicare plans nationwide by visiting Medicare.gov or by
    calling your State Health Insurance Assistance Program (SHIP). See pages
    109–112 for the phone number
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