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 CMS Star ratings.
CMS Star Rating Improvement
UNDERSTANDING the system for CMS STAR RATINGS.
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.
A Long-Term Approach to Quality.
Improving Your Medicare Star Rating
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 CMS Star ratings excellence.
Navigate the Ratings.
Use Our Chart to Calculate
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.
Hear it from the source.
What Our Clients Are Saying
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Richard Perez
Linda O'Donnell
Providence Simon
Trenton Browne
Scott & White Health Plans
YourCare Health Plan
CarePlus Health Plans
Northwest Health
