What are Medicare Star Ratings? Boost Them With Remote Care

Health Plans

What are Medicare Star Ratings? Boost Them With Remote Care

Ash Team

Each year, the Centers for Medicare and Medicaid Services (CMS) gathers information from member satisfaction surveys, plans, and health care providers to measure how well Medicare plans perform. Plans get an “Overall Rating” based on member experience, medical care, and plan administration. Medicare Star Ratings are released every October, and are one of the best ways to differentiate market plans and verify high-quality care.  

Plans that earn at least four stars qualify for federal bonus payments, which must be put toward expanded benefits. These benefits may include additional programs like telehealth services that improve access and quality of care for patients. Medicare plans can utilize telehealth services and other remote care options to improve member satisfaction, meet requirements, and boost overall Medicare Star Ratings. 

Telehealth Optionality 

Medicare Star Ratings measure how quickly patients get appointments and how easy it is to receive care. Telehealth services streamline health care by offering convenient online scheduling, reducing travel time, and enabling remote consultations. Patients can easily book appointments, access virtual visits from the comfort of their homes, and receive timely care. This approach enhances accessibility, especially for those in remote areas or with mobility constraints, fostering a more patient-centric and efficient health care experience.

Medication Adherence 

Medicare Star Ratings calculate medication adherence for diabetes, cholesterol, and hypertension medication. Medication adherence entails following prescribed medication regimens, encompassing dosage, timing, and frequency. It is essential for effective treatment outcomes across health conditions, adherence and ensures patients derive intended benefits.

Success is measured in percentage of Medicare plan members who fill their prescription 80% or more of the time. With the popularity of GLP-1 agonists for diabetes, there is an increased likelihood that providers will use lab testing to measure health targets and decrease overall drug costs. Providers and health care organizations can onboard at-home diagnostics to conduct necessary lab tests in order to remain compliant with GLP-1 medication regulations, enabling patients to fill prescriptions quickly without the need for in-person phlebotomy. 

Population Screening

Population screening can enhance Medicare Star Ratings by identifying and addressing health issues across a broad community. Timely screenings allow for early detection and intervention, preventing the progression of diseases. This proactive approach leads to better health outcomes, increased patient satisfaction, and improved overall quality of care. Consequently, addressing population health through screenings positively influences the metrics and performance indicators that contribute to a higher Medicare Star Rating. Health plans can perform population screening through widespread adoption of at-home diagnostics, sending kits to patients at home. 

For example, the U.S. Preventive Services Task Force recommends patients aged 45 to 75 be screened for colorectal cancer. The FIT test is a non-invasive screening that detects human blood in stool from the lower intestines, indicating potential colorectal cancer or gastrointestinal issues. It involves collecting a small stool sample at home and sending it to a lab for analysis. 

Chat with Ash Wellness about testing for colorectal cancer with at-home FIT screening.

Diabetes Care

As with HEDIS, Medicare Star Ratings prioritize diabetes care. Star Ratings measure the percent of plan members with diabetes who had an HbA1c test during the year that showed their average blood sugar is under control (< 9%), percent of patients with diabetes who received an eye exam, and percent of diabetes patients who received a kidney function test. Plans can onboard at-home diagnostic programs to send kits that screen HbA1c and kidney function directly to patients with diabetes. 

Chat with Ash Wellness about the Ash Platform for at-home HbA1c diabetes testing.

Improve your Medicare Star Rating with Ash Wellness 

Plans can improve Medicare Star Ratings with a strategic focus on telehealth optionality, medication adherence, population screening, and diabetes care. Embracing telehealth services not only improves accessibility but also contributes to positive patient experiences. Medication adherence, measured by plan members filling prescriptions consistently, can be achieved through innovative solutions like at-home diagnostics, reducing non-compliance risks. Population screening, facilitated by at-home diagnostic kits, aids in early disease detection, boosting overall health outcomes. Lastly, prioritizing diabetes care with at-home diagnostic programs ensures essential tests reach patients, promoting better control and management. 

Ash Wellness partners with health plans to launch successful white-labeled at-home diagnostics programs in the United States. The Ash Platform and team of remote diagnostics experts manage an entire end-to-end testing program. This includes the technical integration and support, national set of fulfillment centers, printing facilities, supply chain management, logistics from order to result, compliance management, a network of CLIA/CAP certified labs, data and health reporting, and last-mile client service expertise.

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