Becker’s Payer Issues Podcast Star Strategies: Improving Medicare Ratings with Provider Data
Mar 27, 2024
Industry experts Will Shrank and Jill Hummel discuss strategies to enhance Medicare Star Ratings using provider data, emphasizing the significance of Star Ratings for health plans and the crucial role of accurate provider data in improving member experience. Topics include the impact of Star Ratings on revenue, the importance of quality improvement programs, provider data accuracy, and prioritizing patient care and member experience.
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Star Ratings Impact Revenue and Enrollment
- Star Ratings directly affect Medicare Advantage plan enrollment and retention significantly.
- A one-star increase can boost enrollment by 8-12% and increase revenue by up to 17.6%.
Star Ratings Influence Growth Opportunities
- Star Ratings reflect member experience and health outcomes, crucial to a plan's mission.
- Achieving five stars allows plans to recruit year-round, boosting growth beyond open enrollment.
Provider Data Drives Member Experience
- Accurate provider data is critical for positive member experience and higher star ratings.
- Inaccurate directories cause members to have poor access and disenroll or avoid plans.