A MA Health plan’s Star strategy continues to be critical to its plan success and survival. For a MA Plan to receive a bonus it means an immediate and successful execution of a multi-disciplined strategy across departments. It’s easier said than done.
GHG anticipates that CMS will continue adjusting thresholds, curving the Star Ratings year after year in an effort to separate the remarkable from the ordinary. Now is a critical time – MA Plans must examine not just this year’s score and what contributed to it, but their Plan’s score history in the Stars program and what it says about the enterprise’s overall approach to key issues such as:
• Quality of care,
• Provider contracting and management,
• Data management,
• Member services and engagement,
• Model of care,
• Pharmacy management, and
• Risk adjustment
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.
There is no time to delay. Your organization needs to identify opportunities to increase your Star Rating, implement an enterprise-level strategy, and carefully monitor your progress over the next plan year. We can help you every step of the way with our full portfolio of GHG practices, products and services.