Tag Archives: Star Ratings

Influencing Your 2019 Star Ratings: Every Day Matters

Melissa Smith

With last week’s release by the Centers for Medicare & Medicaid Services (CMS) of draft 2018 Star Ratings to health plans, the now-annual “4th quarter Star Ratings fire drill” has officially begun.  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 to eight 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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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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The True Path to Improving the Medicare Member Experience

John Gorman

I’ve been struck lately by two new research reports that demonstrate improving the member experience is the top challenge facing Medicare Advantage plans. First, JD Power is out with its 2017 Medicare Advantage Satisfaction Rankings. Among the results: Read more

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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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Preserving Your Investment Through the Member Experience

Nilsa Lennig

I was on a client call last week with a few of our Gorman Health Group Sales, Marketing & Strategy subject matter experts presenting a sales and marketing budget the team created to help illustrate pre-operational investments in sales distribution and marketing strategies to a potential “new market” entrant. These budgets are two pieces of a much larger “Go, No Go” analysis we performed for this client, however, the discussion around these budgets led to a question from our client’s CEO that could, in essence, define the future success of this health plan in Medicare Advantage: “Does this budget account for initiatives that will enhance the members’ experience?”

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A New Source of Capital for Star Ratings and Clinical Innovations

John Gorman

For years, every conversation we’ve had with clients about improving Star Ratings and launching clinical innovation projects involved a common barrier to progress: money. So for months, we have been working to bring a new source of capital to the health plan and provider industries to help drive this evolution, called social impact investing. We are getting some early successes and can ask, “If money was no object, what initiatives would you chase?”

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The State of Star Ratings

Melissa Smith

Last week I had the pleasure of spending a few days with some of the industry’s leading experts at our annual client forum. One of my favorite things about this now-annual tradition is the opportunity to look beyond the Star Ratings measures to share innovation experiences, hear more about emerging best practices, and level-set amongst ourselves about past “best practices” that have become “industry standard” (and those that are completely out of date).

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