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STAR RATING OVERVIEW

 

As payment becomes increasingly tied to quality of care, health plans are focusing their efforts on improving their star-rating scores.

The Center for Medicare and Medicaid Services (CMS) rates Medicare Advantage (MA) Plans on a Five-Star scale with results published on the Medicare website and Plan Finder. Starting in 2012, the Patient Protection and Affordable Care Act introduces Medicare Advantage bonuses and rebate levels tied to the CMS five star quality rating. The significance of higher ratings is not to be underestimated. Higher ratings can mean the difference between success and failure.

Many of the 2012 overall rating will be based on 2010 data. 2013 rating is based on 2011 data and so on. Acting now to impact rating positively will determine the financial future of Medicare Advantage plans.

Most health plans today have initiatives to improve their star ratings. These projects are handled manually using information that is not real time or readily available. Disparate and fragmented systems place significant demand on overworked IT resources resulting in data collection activities that are time consuming and inefficient.

INTRODUCING iSPACE CARE METRICS

 

Health plans need to change the way their star metrics projects are currently managed if they wish to improve their rating.

The technology platform supporting the process should be specifically built to accept data from multiple sources, identify opportunities for improvement and provide the functionality to develop projects around those opportunities. An end-to-end solution makes the insight gathered from the analytical process actionable and tracks the improvement projects to closure.

iSpace Care Metrics provides a powerful advantage in improving and maintaining star ratings through effective and efficient use of your data and internal resources.

Care Metrics provides a powerful advantage in improving and maintaining star ratings through effective and efficient use of your data and internal resources.

Care Metrics can:
  • Analyze your current ratings and scores across all domains and measures
  • Identify root causes and opportunities for improvement of gaps in care
  • Prioritize projects with highest return
  • Track and review progress of interventions

iSpace can help you control your data and help manage the process of improving your star ratings. To learn more about Care Metrics, click here

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