In our last blog post, we began to discuss how MAPD plans, amid so much market uncertainty, have the potential to not just control but improve their Star Ratings. Here, we build on that blog to discuss identifying the right members to reach and refining intervention methods to meet those members’ individual needs.

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.

At the end of January 2019, CMS released notice of impending changes to the methodology of Medicare Advantage (MA) “Capitation Rates and Part D Payment Policies.” There are a few primary changes that MA Part D (MAPD) plans will want to know about. Here’s the summary, and we’ve added some notes for places RxAnte can help.

As we begin a new year, plans are developing strategies to focus their quality efforts amid the possibility that CMS Star Ratings cut points increase again. A core competency of RxAnte is helping plans improve pharmacy quality scores against these thresholds. We do that year after year by following four key principles.

The Star Ratings success of Medicare Advantage Part D (MAPD) plans working with seniors and the Low-Income Subsidy (LIS) program depends on how plans handle this special population. Here are the opportunities plans have to improve care and outcomes of LIS members.

Polypharmacy is a problem that belongs to all of us in the healthcare industry, which is why we need to address it together. If we want to really solve it, we’ll have to use analytics the way it was intended – leveraged as a powerful tool in a systematic approach.

There’s a grossly unaddressed problem in the industry for Medicare Advantage Part D (MAPD) plans. That problem is the ambiguous role of  “predictive analytics.” Well today, we’re throwing down the gauntlet and questioning the purpose and value of predictive analytics.