Skip to main content
Glama

Get Star Benchmark

get_star_benchmark
Read-onlyIdempotent

How a Medicare Advantage contract performs on the Star measures against the market, its peers, its competitors and CMS's cut points, over time. Two views in one answer. FAMILIES: for each measure family (all measures, HEDIS, HOS, CAHPS, pharmacy, complaints and leaving, appeals, call center, plan reporting) and each rating year, the contract's actual performance % (CMS-weighted mean of its measure scores; lower-is-better rates counted as their complement, so 10% readmitted = 90%; complaints per 1,000 and improvement scores are counted, not averaged), the 4-star line over exactly the measures it was scored on, and its weighted star; beside the market (member-weighted and one contract one vote), a cohort (default: its dominant product in its dominant state, e.g. D-SNPs in NY), its peer class (national carrier, Blue Cross Blue Shield plan, Kaiser, provider-sponsored, regional plan, MA-focused entrant) and the average of its five nearest competitors. MEASURES: for the latest rating year, every measure's score, star, CMS message where there is no score, the 2-5 star cut points, the market mean (members and contracts), median and middle half, the cohort mean, the gap to the market (positive = better, direction-aware), the percentile among MA contracts, and each competitor's score.

ARGUMENTS: contract_id (required, H or R contract, e.g. H5549), rating_year (default the newest held), years (1-13, default 5), cohort (one of product_state, product, peer_class, parent, peer_class_product, cai_group, size_band, star_band, state, org_type; default product_state), family (optional: restrict the measures view to one family, e.g. hedis), limit (measure rows, default 60).

RETURNS value.summary (contract, rating year, parent, peer class, product, state, members, the cohort used, the five competitors with their parents and shared-county members), value.families (one row per family per year) and value.measures (one row per measure, latest year).

RULES THE TOOL ENFORCES: every number is read from the stored benchmark tables, never averaged at call time; a score belongs to the whole contract, so a contract sits in the one product and state holding most of its members; text cells (plan too small, not enough data) are counted and never imputed; CAHPS cut points are approximate because CMS also tests significance; stand-alone drug plans are a separate market and are not included.

SOURCE: CMS Part C and D Star Ratings data tables and CMS monthly enrollment, through Vlada's measure benchmark engine (stars_measure_benchmark@1.0.0).

Input Schema

TableJSON Schema
NameRequiredDescriptionDefault
limitNo
yearsNo
cohortNo
familyNo
contract_idYes
rating_yearNo

Output Schema

TableJSON Schema
NameRequiredDescriptionDefault
unitNo
as_ofNo
valueYes
sourceYes
statusNocomplete
caveatsNo
failureNo
qualityNo
refusalNo
vintageNoas_restated
audit_idYesUUID; ties to medicare_silver.audit_log row.
signatureNo
tenant_idNoCalling tenant slug, resolved by the binding and stamped via the per-call tenant context. Defaults to the bootstrap 'internal' tenant for local/in-process callers.
timestampYes
confidenceNo
data_as_ofNo
request_idYes
methodologyNo
snapshot_setYes{table_fqn → iceberg_snapshot_id (int64)}. Per M-2 §2.2.
tool_versionYes
response_hashYesSHA-256 of canonicalized form per M-2 §2.4.
result_statusYes
vintage_basisNodefault_unmeasured
as_of_assertedNo
as_of_observedNo
parse_revisionNo
as_of_effectiveNo
freshness_stateNounknown
methodology_eraNo
confidence_basisNo
semantic_versionYes
invariants_appliedNo
finality_confidenceNo
cms_vintage_sequenceYes
parser_artifact_hashYes
methodology_blend_factorsNo
parser_artifact_hash_basisNonot_evaluated

Schema Changelog

Changes observed during successful MCP inspections.

  1. Added

TDQS

Score is being calculated.

Try in Browser

Glama MCP Gateway

Add one secure layer between your agents and this server.

Resources