ARTICLE
September 12, 2023
The Centers for Medicare & Medicaid Services’ (CMS) release of Plan Preview 2 has triggered a rush to download the data, review cut points, prepare communications for leadership and attempt to take a moment to digest reality. The drafted ratings led to either a long night of hard work or a night of great sleep as plans return to cope with post-public health emergency Star Ratings norms filled with new measures, a lack of COVID relief and significant unpredictability. We will hear some great success stories from Plan Preview 2, even though others may feel frustrated or paralyzed as they digest their ratings.
Balancing Analytics and Action
Those who have been in Star Ratings for several years know that the next few weeks will be filled with time-consuming analysis, reporting and presentations about the 2024 Star Ratings. Immense amounts of time will be spent inspecting every nuance related to historical plan performance and constructing explanations of what happened, whether good or bad. This time is necessary but needs to be balanced with the reality that time is our most precious asset – and spending too much capacity on historical analysis can prevent key personnel from doing the hard work needed to sustain or improve this year’s performance.
We cannot lose focus on the impact the next 110 days (about three and a half months) will have on Measurement Year 2023. There is still time to achieve your goals, re-adjust cut points to align with Tukey impact and build out the “blocking and tackling” needed for a strong end-of-year push.
Keep Focus on 2023
The final days in Measurement Year 2023 will pass quickly. We cannot lose track of what is needed to reach our goals. Star leaders must focus on quality areas where there is still low-hanging fruit to meet and surpass their measure targets. The next few months are not the time for big thinking or to focus on utopic innovation concepts with multi-year return-on-investment (ROI).
Through the years, I have seen many plans achieve their Star performance goals by prioritizing fourth quarter on the measures they can impact quickly.
Take this time to:
- Focus on HEDIS® measures within reach of your target. Ask members if they need help setting appointments or have already completed services so you can collect charts. Get exponential ROI from each intervention by adding a few key CAHPS® questions to determine whether a CAHPS barrier is the root cause of the HEDIS gap.
- Micro-manage Medication Adherence measures and target those members who need just one more fill to be compliant and those with very few “lag days” before they become unrecoverable for the year.
- Prepare for the foreign language interpreter and teletypewriter audit through testing and training of staff.
- Resolve member issues quickly to improve their experience and reduce disenrollment during the Annual Enrollment Period.
The path may be short, but the opportunities for quick hits are available. See below for more ideas you can implement quickly to meet your 2023 goals:
Healthmine is here to help. Reach out to me at John.Willis@healthmine.com with any questions on how we can help you achieve your goals.