CMS Star Rating Improvement

CMS Star Rating Improvement 1

UNDERSTANDING THE MEDICARE STAR RATING SYSTEM.

Five-Star Quality Rating

The Centers for Medicare & Medicaid Services (CMS) uses a five-star quality rating system to measure the experiences Medicare beneficiaries have with their health plan and health care system. Health plans are rated on a scale of 1 to 5 stars, with 5 being the highest. The system rewards plans that achieve certain benchmarks for multiple quality measures.

The overall plan rating provides a single summary result that makes it easy for participants and prospective members to compare plans based on quality and performance. Visit the Medicare Plan Finder Tool on www.medicare.gov to learn more about plans and see their ratings.

CMS Star Rating Improvement 2

A Long-Term Approach to Quality.

Improving Your Medicare Star Rating

DTS Group has completed Medicare Advantage Stars improvement projects for dozens of health plans. We help develop Star Rating Improvement Strategies that uses detailed contract-level and specific competitive plan data in context with cut-points and rating thresholds. This allows us to identify the measures and improvement opportunities most likely to impact Star ratings.
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Reaching Stars Excellence.

Stars Outreach and Action Plans

The result is targeted information plans can use to implement interventions and increase data capture. DTS Group will help your organization prioritize short-term efforts and implement an integrated long-term strategy for Stars excellence.

Navigate the Ratings.

Use Our Chart to Calculate

CMS Star Rating Improvement 5

The Medicare Star System includes 47 quality measures: 33 measures for Part C and 14 measures for Part D. For Medicare Advantage plans with a Part D Prescription drug benefit (MA-PD), Two measures are included in both the Part C and Part D. In these instances, only the Part C scores of the two overlap measures count toward the total.

Program Considerations

Administrative
Claims Data

Healthcare Effectiveness Data and Information Set (HEDIS) and medication adherence

User-Friendly
Interface

Consumer Assessment of Healthcare Providers and Systems (CAHPS) and Health Outcomes Surveys (HOS)

Membership
Satisfaction Surveys

Appeals Timeliness, Call Center Performance, Enrollment Processing, Etc.
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Hear it from the source.

What Our Clients Are Saying

“DTS Group makes a complex audit easy to navigate. The process is organized logically and my team enjoys working with the professionals at DTS Group. I would not use any other audit firm. Also, their conference is a lot of fun!”
"DTS Group differentiates themselves with amazing customer support. They are available to us 24x7 / 365. Their approach gives us confidence our audit results will be complete and correct. If you are looking for a true partner in compliance reporting then you are in the right place."
"When we selected DTS Group to conduct our audits we gained a skilled partner in performance reporting. DTS Group’s commitment to customer service and our success is unmatched. They are our Five-Star auditors."
“DTS Group works with many 5-Star plans and they understand the pressure and competing priorities we face. They respect my time while we work together to complete the audit. Their efforts are focused, timely, and relevant”
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Richard Perez
Linda O'Donnell
Providence Simon
Trenton Browne
Scott & White Health Plans
YourCare Health Plan
CarePlus Health Plans
Kaiser Permanente Northwest
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READY TO GET STARTED?

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