The Voice of Melissa Smith

Melissa Smith

About Melissa Smith

Melissa Smith is the Vice President of Stars & Quality Innovations at Gorman Health Group (GHG). She brings more than 20 years of healthcare experience to GHG, more than five of which have been in an operational leadership capacity in Medicare Advantage (MA) and Part D health plans.

Influencing Your 2019 Star Ratings: Every Day Matters

Melissa Smith

With the recent release by the Centers for Medicare & Medicaid Services (CMS) of 2018 Star Ratings to health plans, the now-annual “4th quarter Star Ratings fire drill” is officially underway.  Whether you dropped below the 4-star threshold required to earn quality bonus payments, or you hit 4 stars and are hoping to sustain it, the next six weeks are critical to your success. But with only about 90 days remaining to connect members with the care they need for your success, every day and every decision matters.

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CMS Launches Patients over Paperwork Initiative Focused on Quality Measurement

Melissa Smith

As the Centers for Medicare & Medicaid Services (CMS) embarks on its Patients Over Paperwork initiative to better focus quality measurement in all programs on meaningful measures, this is an ideal time for Medicare Advantage plans to ensure they are using their data in ways which support CMS’ plans to reduce unnecessary burden, increase efficiencies, and improve the beneficiary experience.

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2018 Star Ratings: Top Takeaways

Melissa Smith

In case you missed our 2018 Star Ratings webinar yesterday, here are some of our top takeaways:

Strategy is vital for sustained success. Many plans’ Star Ratings success is the product of multi-year, strategic investments to improve infrastructure, processes, culture, and execution. When Star Ratings efforts are designed only with the “short-term win” in mind, we are often limited to narrowly-defined tactics and projects – however, when they are strategically designed, Star Ratings activities can be hardwired into corporate culture and standard processes so strong Star Ratings are simply the measurement of high-quality service delivery.

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2018 Star Ratings Offer Valuable Insight into Competitive MA Industry

Melissa Smith

The Centers for Medicare & Medicaid Services (CMS) release yesterday of the 2018 Star Ratings offers valuable insights into the significantly competitive Medicare Advantage (MA) industry. Here are just a few early observations and some insight into why it’s important: Read more

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Evaluating Star Ratings Performance Data

Melissa Smith

September marks an exciting season for Star Ratings as 4th quarter work plans and 2018 budgets are finalized. For these investments to be impactful, plans must carefully evaluate Star Ratings performance data to ensure action plans address the following questions: Read more

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Star Ratings – First Plan Preview is Underway!

Melissa Smith

The First Plan Preview period for the 2018 Star Ratings began last week with the Centers for Medicare & Medicaid Services’ (CMS’) release of measure rates and an initial draft of the technical notes. As is always the case, CMS is allowing only a very short review period with all feedback due by THIS FRIDAY, August 18 – so time is of the essence!

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Preparing for First Plan Preview of 2018 Star Ratings Data

Melissa Smith

While many of us have been enjoying the long days of summer and catching our breath after the Healthcare Effectiveness Data and Information Set (HEDIS®) season, the Centers for Medicare & Medicaid Services (CMS) has been hard at work preparing for the annual ritual of releasing the latest Star Ratings and program changes. Here’s an idea of what we can expect over the next few months:

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