Challenge

CMS STAR ratings have major significance for Medicare Advantage plans in the form of bonuses, rebates, and stronger member enrollment. It is crucial for healthcare plans to proactively manage their performance measures to improve business results and achieve higher ratings by focusing on closing patient care gaps and improving general customer satisfaction.

Improving STAR ratings is becoming more and more challenging. Organizations find their datasets harder to analyze and face changing measures every year.

Solution

Knowing where to focus effort makes all the difference in moving the needle for your STAR rating. The Concord team has helped large and medium-size health payers obtain better data clarity and streamline the decision support for STAR measures. As part of our solution toolkit, we design and implement an application that helps health plans improve their STAR rating quickly and efficiently. Our application focuses on:

• Tracking Performance. Our application helps health plans track the performance of all contracts and drive actionable insights of low-performing contracts.
• Comparing Ratings. Health plans can compare performance with average measure ratings across health plans to understand better where to focus efforts.
• Guiding Next Steps. Our team designed a specific model to identify target measures and highlight weak KPIs to help guide next steps.
• Projecting Results. Our specialized dashboards provide insight on the required level of ratings boost across key measures to achieve an overall STAR rating lift.