6 Steps to Improve Your Health Plan's Star Ratings

In a recent article published by Managed Healthcare Executive, Senior Vice President of Market Strategy and Consulting at HMS, Ellen Harrison, discusses the fact that many payers often overlook key opportunities to improve HOS and CAHPS measures.

Here are six steps Ellen shares to build an action plan and directly address (and improve) key measures that impact your health plan's Star Ratings:

1. Perform an off-cycle survey targeting your entire membership to gather member-level detail, barriers to care, and insights into member perceptions.

2. Address high-risk members immediately by using triggers or alerts to identify those members based on negative responses. Once identified, provide immediate support through Care Management or Customer Service in order to mitigate possible issues and demonstrate your commitment to members.

3. Utilize survey insights to drive members to care and disease management programs that best meet their needs.

4. Expand your survey's data set to also include specific questions about barriers to care, health and health insurance literacy, and social determinants of health.

5. Perform data analysis and data correlations across HOS and CAHPS question responses to best understand trends and identify key intervention opportunities. Compare HOS outcomes to CAHPS access, timeliness, and care coordination.

6. Drive continuous improvement in HOS and CAHPS measures with a multi-year strategy. Focus your resources on a limited number of interventions to drive results at first, and then expand to additional interventions in the following years.

Read the full article here.

To learn more about improving your Star Ratings, read the HOS and CAHPS eBook.


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