It’s official — the Star Ratings busy season is officially underway. The Centers for Medicare & Medicaid Services (CMS) recently notified plans of the first preview period for the 2017 Star Ratings data.
Although CMS did not introduce any surprises or unexpected measure changes as part of the first plan preview, plans have only a very short window to review their data for accuracy, with feedback due to CMS by August 18, 2016. Inevitably, some plans identify data issues or inaccuracies during this plan preview, so great care should be taken to validate each measure score and data element provided for review.
While the Healthcare Effectiveness Data and Information Set (HEDIS®), prescription drug event (PDE), and administrative measure scores likely contained no surprises for health plan leaders, the first plan preview data for the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) and Health Outcomes Survey (HOS) measures may contain some surprises. Improving performance on CAHPS® and HOS measures generally requires carefully planned engagement with both providers and members over a sustained period of time. With almost half of the annual member survey cycle already behind us, it is critical for plans to re-evaluate their current Star Ratings status to pinpoint high-risk CAHPS® and HOS problem areas in order to ensure the right activities are in place with the right members and providers to achieve desired improvements.
During the first plan preview, particular attention should also be paid to validating the Categorical Adjustment Index factor data, which will be used for the first time this year to account for the impact of socio-economic factors and disability status on quality measure performance.
Need assistance making sure your fourth quarter action plan is aligned with your highest risks or interested in assistance preparing for 2017? We can help. For questions or inquiries about how Gorman Health Group can support your Star Ratings program, please contact me directly at email@example.com.
GHG’s Star Rating team has been working on the critical factors that drive your Stars score for more than 15 years. Since the inception of the Star Bonus Program, we have supported dozens of clients, including small regional plans, multi-market players, and multiple Special Needs Plans (SNPs). We know what works and what doesn’t, and we see where MA health plans continue to miss real opportunities to greatly impact their Star score. Visit our website to learn how we can help you with your Star Ratings program >>
Stay connected to industry news and gain perspective on how to navigate the latest issues through GHG’s weekly newsletter. Subscribe >>