CMS Rewards Program Guidance

Recently, the Centers for Medicare and Medicaid Services (CMS) finalized its guidance on Rewards and Incentive Programs. These Medicare guidelines are applicable today and enable Medicare Advantage plans to offer health-driven incentive programs that may be applied to an expanded list of health-related services and activities. However, some restrictions in the structure and framework of these programs must be taken into account to succeed.

Done compliantly and within Medicare guidelines, Medicare incentive programs can create market/product differentiation, improve Medicare Star Ratings and quality – and be part of broader Medicare member engagement. To help guide your strategic thinking, we’ve developed this new Rewards Guide, including Medicare incentives strategies for:

  • Attracting new members
  • Medicare Star Ratings
  • Medicare member engagement
  • Avoiding discrimination
  • Aligning with new restrictions


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