Posted October 5, 2017 by Amy Salls
The Centers for Medicare & Medicaid Services’ (CMS) dramatic changes to the 2018 Star Rating cut points have proven that taking a "cruise control" approach to quality performance will no longer ensure you remain a 4 or 5 Star plan. Achieving and maintaining high marks is a moving target and to be successful, you should find ways to work smarter, not harder, to impact quality scores.
Did your plan unexpectedly miss the 4 Star thresholds causing you to lose your Quality Bonus Payment incentive? Perhaps you just narrowly made the cut but the margin was too close for comfort?
Here are five points to consider as you continue to review your 2018 scores and work to adjust your plans and strategies for future Star Ratings success.
CMS has given us a lot to think about based on 2018 overall plan Star quality performance. Some of the changes to thresholds and scoring methodology were expected, but others took the industry, and possible your rating, by surprise. But don’t panic, there is still time to impact your 2019 performance. Use the last few months of 2017 to look at measures where you didn’t perform as well as you would have liked and put together a work plan that can help you quickly identify members who would benefit most from year end, targeted interventions. If you find that you have a gap in the people, processes, or technology needed to do so, reach out to us to find out how our quality management solutions can help.