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2025 Medicare Part C & Part D Reporting Requirements & Data Validation

Translating Findings into Scores at the Standard/Sub-Standard & Reporting Section-Level

Table 26 illustrates how the 7 sub-standards (1.a – 1.g) of Standard 1 are scored using both binary and Likert scoring systems. Under binary scoring, “Yes” findings for Sub-Standards 1.a, 1.e, and 1.f, each contribute 1 percentage point, and the “No” finding for Sub-Standard 1.g contributes 0 percentage points to the Standard 1 score. Under Likert scoring, a finding of 2 for Sub-Standard 1.b contributes 0 percentage points, a finding of 4 for Sub-Standard 1.c contributes 0.75 percentage points, and a finding of 5 for Sub-Standard 1.d contributes 1 percentage point to the Standard 1 score. Taken together, the actual score in this example is 4.75 percentage points out of a maximum possible score of 7.00 percentage points for Standard 1.

Table 26: Example of Binary vs. Likert Scores Assigned to Data Validation Standard 1
Standard/Sub-Standard ID
(1)
Reviewer's Finding
(2)
Maximum Possible Score
(3)
Actual Score
(4)
Explanation
(5)
1.aYes1.0%1.0%Binary: Yes = 100%
No = 0%
1.b21.0%0.0%Likert: 1,2,3 = 0%
4 = 75%, 5 = 100%
1.c41.0%0.75%Likert: 1,2,3 = 0%
4 = 75%, 5 = 100%
1.d51.0%1.0%Likert: 1,2,3 = 0%
4 = 75%, 5 = 100%
1.eYes1.0%1.0%Binary: Yes = 100%
No = 0%
1.fYes1.0%1.0%Binary: Yes = 100%
No = 0%
1.gNo1.0%0.0%Binary: Yes = 100%
No = 0%
Totals7.0%4.75%
Table Description

This table demonstrates how the 7 sub-standards (1.a – 1.g) of Standard 1 are scored using both binary and Likert scoring systems. It includes the sub-standard ID, the reviewer's finding, the maximum possible score, the actual score, and an explanation.

  • Sub-Standard 1.a:
    • Reviewer's Finding: Yes
    • Maximum Possible Score: 1.0%
    • Actual Score: 1.0%
    • Explanation: Binary scoring: Yes = 100%, No = 0%
  • Sub-Standard 1.b:
    • Reviewer's Finding: 2
    • Maximum Possible Score: 1.0%
    • Actual Score: 0.0%
    • Explanation: Likert scoring: 1,2,3 = 0%, 4 = 75%, 5 = 100%
  • Sub-Standard 1.c:
    • Reviewer's Finding: 4
    • Maximum Possible Score: 1.0%
    • Actual Score: 0.75%
    • Explanation: Likert scoring: 1,2,3 = 0%, 4 = 75%, 5 = 100%
  • Sub-Standard 1.d:
    • Reviewer's Finding: 5
    • Maximum Possible Score: 1.0%
    • Actual Score: 1.0%
    • Explanation: Likert scoring: 1,2,3 = 0%, 4 = 75%, 5 = 100%
  • Sub-Standard 1.e:
    • Reviewer's Finding: Yes
    • Maximum Possible Score: 1.0%
    • Actual Score: 1.0%
    • Explanation: Binary scoring: Yes = 100%, No = 0%
  • Sub-Standard 1.f:
    • Reviewer's Finding: Yes
    • Maximum Possible Score: 1.0%
    • Actual Score: 1.0%
    • Explanation: Binary scoring: Yes = 100%, No = 0%
  • Sub-Standard 1.g:
    • Reviewer's Finding: No
    • Maximum Possible Score: 1.0%
    • Actual Score: 0.0%
    • Explanation: Binary scoring: Yes = 100%, No = 0%

Totals:

  • Maximum Possible Score: 7.0%
  • Actual Score: 4.75%

Refer to Section 2.1 of Appendix J for more information on reporting section scores.