How to Improve Star Ratings for Enhanced Health Plan Performance

Star Ratings impact health plan performance through enrollment, retention, and bonus payments. A decrease from 4 to 3 stars can affect revenue and market position.

For Medicare Advantage plans, addressing care gaps and improving ratings is critical as CMS emphasizes transitions of care metrics with narrow timeframes. Challenges include:

• Lack of real-time awareness, with claims data lagging 1-3 weeks
• Limited data exchange between payers and providers
• Difficulty meeting documentation for transitions of care

Explore this e-book to improve your Star Ratings performance.