star measure
star_meas_cdDefinition
ISO-11179 Definition
An individual clinical quality, patient experience, or administrative performance indicator included in the CMS Star Ratings calculation for Medicare Advantage and Part D plans, weighted by CMS to reflect clinical importance and evidence strength in producing the overall summary star rating. Star measures are organized into domains including staying healthy screenings and tests, managing chronic conditions, member experience with the health plan, member complaints and appeals, and health plan administrative performance. Triple-weighted measures receive three times the standard weight in star calculations and disproportionately influence overall ratings — healthcare data teams identify triple-weighted measures as the highest priority for quality improvement investment.
CMS updates the star measure set annually through the annual Notice of Final Payment and Policy Changes, adding new measures and retiring measures that no longer differentiate plan performance. Healthcare data teams maintain current star_meas_cd reference tables with measure weights, domains, and applicable benchmarks to support accurate star rating projections.
Standard Abbreviation
star_meas_cd
Category
Production DDL — FACT_QUALITY_MEASURE
CREATE OR REPLACE TABLE FACT_QUALITY_MEASURE (
qlty_key INTEGER NOT NULL -- surrogate key,
mbr_key INTEGER NOT NULL -- FK to DIM_MEMBER,
plan_key INTEGER NOT NULL -- FK to DIM_PLAN,
meas_yr SMALLINT -- measurement year,
hedis_meas_cd VARCHAR(20) -- HEDIS measure code,
denom_ind CHAR(1) -- denominator eligible,
numer_ind CHAR(1) -- numerator met,
excl_ind CHAR(1) -- exclusion indicator,
gap_open_ind CHAR(1) -- care gap open,
star_rtg_nbr DECIMAL(3,1) -- star rating,
qlty_scr DECIMAL(5,2) -- quality score,
perf_thrsh_pct DECIMAL(5,2) -- performance threshold,
raf_scr DECIMAL(10,3) -- risk adjustment factor,
outreach_cnt SMALLINT -- outreach attempts,
load_dt TIMESTAMP_NTZ NOT NULL -- load timestamp
);
Standard Snowflake DDL for the canonical quality table. Convert to BigQuery or Databricks →
Why This Term Matters
Quality measure data determines how payers and providers are rated and reimbursed under CMS Stars, HEDIS, and value-based care contracts. Data engineers who understand quality terminology build measure calculation pipelines that correctly attribute patients, apply denominator exclusions, and flag documentation gaps before submission deadlines. Incorrect quality data directly affects star ratings, pay-for-performance bonuses, and Medicare Advantage plan bids.
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