If you’re leading a Medicare Advantage Part D (MAPD) plan, we know you have a lot on your mind right now. Rising cut points, changing CMS rules, evolving Medicare trends, the dos and don’ts of an increasingly data-driven world – it’s been on our minds, too. As we’ve pored over the industry-level data from CMS, we realized many MAPD plans are missing a huge opportunity to impact Star Ratings. It seems logical to us – “making more of medicines” is our motto, after all – but plans simply aren’t “making more” of medication adherence strategies. To help you combat that, we’ve done a few things recently that you ought to check out:
The Ultimate Resource for Part D Adherence Strategic Planning
We created and published the Field Guide to Creating and Managing an Effective Part D Stars Adherence Program. This guide gives away a lot of our secrets, but it’s worth it. We genuinely believe quality healthcare shouldn’t be treated as a privilege, it should be treated as a right. Arming plans with the information they need to get ahead on triple-weight quality measures is one small way we can help make that happen.
Relief from the Administrative Burden of Interventions/Outreach
We patented the system (RxEffect) that’s helping our national and regional plans raise adherence rates by as much as 8.2%. Patenting gives us the opportunity to make the system stronger and better than ever, creating a truly advantageous tool for MAPD plans. You can use this tool to manage internal workflows, establish outreach and intervention rules to create actual improvements, and more.
Impact the Future of Star Ratings, Quality Measures, and Cut Points
We have been following what CMS has been making proposed rule changes to this year, and it will impact MAPD plans in big ways. Specifically, CMS has been talking about restructuring everything from drug prices to what’s included in quality measures, but the rules aren’t final yet. We’re working on our own comments and response to CMS rules CMS-4180-P (Drug pricing) and CMS-4185-P (Part D flexibility). We encourage our clients – and you – to do the same.
Improve Strategies to Improve Medication Adherence
We’ve created an actual tool that you can use to see how different your Star Ratings would be if your medication adherence rates were improving year-over-year (as they do for our clients). The fact of the matter is that 37 percent of overall five-star performance depends on medication adherence. If you’re not maximizing and optimizing medication adherence at the member and population levels, you’re missing out on one of the quickest ways to get more bonus dollars. Use the tool we created to see the impact adherence measures have on dictating if your plan is a high- or low- performer (and whether or not you get a Stars bonus).
Other Questions? We Can Help.
Contact us for a consultation, demonstration, or simple person-to-person conversation and see what making more of medicines can do for you.