Key areas impacting Star Ratings include which of the following?

The correct answer, focusing on member satisfaction and experience, is vital because Star Ratings are heavily influenced by the feedback and experiences of members within a healthcare plan. These ratings serve as a critical metric for evaluating the quality of care that members receive and how they perceive the services offered by their plan.

Member satisfaction is assessed through various surveys, including the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, which gauge aspects such as communication with doctors, ease of getting needed care, and overall member experience. High satisfaction scores often lead to better Star Ratings, as they reflect the plan’s effectiveness in meeting member needs and expectations.

In contrast, while complaints can play a role in determining satisfaction, they do not capture the broader spectrum of member experience, making them less comprehensive alone. Premium costs and claim processing times, while relevant factors in healthcare delivery and member decision-making, do not directly influence the Star Ratings as member satisfaction does.