Medicare Advantage Star Ratings Declined Again for 2024 - IMAT Solutions
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25 Oct Medicare Advantage Star Ratings Declined Again for 2024

Enhance Star Ratings with IMAT’s Data-as-a-Service (DaaS) Solution

When it comes to Medicare Advantage (MA) Star Ratings, we may be seeing history repeating itself.

This time last year, CMS released its 2023 Medicare Advantage and Part D Star Ratings, which found an overall decline in ratings when compared to 2022. During this time, it was reported that 57 contracts earned five stars, which was down significantly from 74 the previous year.

Ahead of Medicare open enrollment this year, CMS announced that Star Ratings fell for the second year in a row to 4.04 and 3.11 stars.

In addition, 42 percent of Medicare Advantage plans that offer prescription drug coverage will have a Star Rating of four or more in 2024. This is another substantial decrease from 51 percent in 2023 and 68 percent in 2022.

According to this recent Healthcare Finance article, we are seeing Star Ratings returning to pre-COVID-19 numbers. The article discusses how CMS relaxed its measures during the pandemic two years ago. Today, CMS has returned to its pre-pandemic approaches, and the financial fallout is significant for MA plans.

As we highlighted last year, the decline in 2023 Star Ratings had a direct impact on MA plan revenue growth. During this time, several MA plans started to track internal improvements, and have put the right systems in place for 2024. We will likely see earnings reports soon about the financial impact of the latest Star Ratings.

With this in mind, now’s the time for MA plans to develop new plans and strategies for boosting their Star Ratings for 2025. One of the core ways to enhance Stars ratings is to gain optimal results from clinical data.

The IMAT’s Data-as-a-Service (DaaS) Solution allows health payers to do this, while also boosting revenue, enhancing member care and achieving compliance. It helps payers to improve overall HEDIS reporting capabilities and STAR ratings because of its Validated Data Stream designation in the new NCQA Data Aggregator Validation (DAV) program.

IMAT’s DaaS solution ingests the clinical data obtained from Provider EMRs on a real-time basis and prepares the data for validation by NCQA, so that it can be used as standard supplemental data in HEDIS reporting.

This eliminates the need for primary source verification (PSV) and the HEDIS audit process. This also saves time and money for aggregators, provider organizations and health plans.

Finally, Clinical Data Integration (CDI) is the foundation for the DaaS offering. IMAT Solutions was recently highlighted as a CDI vendor in Gartner’s “Clinical Data Integration Capabilities and Sourcing Recommendations for U.S. Healthcare Payers” report.

Are you ready to boost care outcomes and enhance your overall Star Ratings?

Please contact us to schedule a 20-minute demo of the IMAT DaaS solution with our experts who have a combined 40 years of experience in healthcare informatics.

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