28 Oct Data Analytics Key for Medicare Advantage Star Ratings

According to a recent report from McKinsey & Company, health payers need to take into account member surveys and data analytics for best meeting new Medicare Advantage Star Ratings programs.

The report also highlights how CMS has put a heavier emphasis on enhancing the member experience, which is already a fundamental aspect of Medicare Advantage Star Ratings. For example, it already confers around $15 billion in incentives, and by 2023 it will make up 57 percent of the overall Star Ratings scores.

McKinsey & Company also recommends using advanced data analytics to identify their target member populations and individuals. In addition, the use of episode analytics will help payers to predict healthcare spending and member behaviors for ultimately mapping and isolating member priorities.

For health payers, now is the right time to consider using the right data analytic solutions to help enhance Star ratings.

For example, IMAT Solutions was recently cited in “U.S. Healthcare Payer CIOs Boost Medicare Advantage Star Ratings Using Engagement Hubs and Insights” Report.

In this report, IMAT Solutions is named as a representative vendor offering Core CDI capabilities that allow payers to align business processes across quality improvement, risk adjustment optimization, care management and payment integrity.

IMAT also allows payers to mine the unstructured portion of the EHR for evidence that a member is either excluded from a measure or is compliant, which often does not appear in claims.

For example, IMAT Solutions offers quality measurement dashboards that help payers gain a clearer picture for meeting these data quality metrics. The company’s solutions also support payers’ ability to meet the HEDIS, NCQA, STARS and other data quality measures.