In this three-part blog series, we give MAPD plans the intel they need to improve 2020 Star Ratings and get ahead of 2021 cut points.
Medicare Advantage Part D (MAPD) plan leaders face a series of growing challenges, ranging from rising cut points to evolving CMS rules to intensifying spending pressures. One of the biggest challenges, however, is within a plan’s control: CMS Star Ratings.
What quality measures impact Star Ratings the most?
Improving Star Ratings and getting those much-needed bonus dollars requires MAPD plans to focus their resources at the right measures while using the right tactics to ensure cohesion across collective quality initiatives. But what are the right measures? What are the right tactics? Star Ratings cover almost everything imaginable related to patient experiences and outcomes. Meanwhile, plans are already working against tight margins and scrambling with new federal regulations. Fortunately, it’s not complicated to determine what “right” is. Just look at the numbers: CMS data shows us that 96 percent of high-performing plans have a 4- or 5-star rating for medication use quality measures.
If you need further proof, consider the fact that roughly 50 percent of overall quality measure ratings are now impacted by medication use measures. Imagine controlling even half of that 50 percent – improving your odds and advancing your ratings of that 25 percent can be the difference in thousands of bonus dollars per covered life per year.
What is the best way to improve medication-use measures?
The trick is finding the right tactics to fuel medication-use strategies – and we can answer that with one deceptively simple-sounding word: analytics.
It’s deceptive because “analytics” has come to be synonymous with “reviewing some data.” Although technically correct, it only captures the process of analytics, not the use or the value of analytics. Specifically, it doesn’t cover the four, key ways analytics can add value by affecting proven Star Ratings change:
- Targeting: Identify members in a more intentional way.
- Timing: Refine intervention methods to meet members’ individual needs.
- Effectiveness: Enhance predictive value to inform tactical execution and strategic planning.
- Scale: Impact care delivery by gaining greater control over where and how it happens.
What else can plans do with analytics to impact Star Ratings?
For plans that understand the four roles of analytics and how to apply them to their own quality measure approaches, anything is possible. That’s why we’re bringing you this three-part blog series outlining everything MAPD plan leadership needs to know to apply analytics in ways that drive quality measure improvement. Keep an eye out for our post next week on identifying members and refining interventions.
In the meantime, check out these other resources:
- Analytics Programs
- Advanced Analytics
- Implementing Analytics
- Retroactive vs. Predictive Analytics
- Value of Analytics