Build a Comprehensive Enterprise Strategy to Improve Star Ratings
Medicare Advantage plans receive bonus payments based on quality ratings provided by CMS. With the growing adoption of digital technology, members today are more informed and are likely to join a MA Plan that are ranked higher in CMS’s Plan Finder (based on Stars ratings). Most MA enrollees prefer plans with 4 Stars or above and hence it is pivotal that MA plans maintain high scores.
Stars Decision Engine is an AI/ML driven solution for Medicare Advantage Plans to execute their annual CMS Stars program by combining FluidEdge’s business consulting expertise and CitiusTech’s digital transformation solutions.
Healthcare Consulting Professionals
Key Solution Highlights
Identify focus measures and align enterprise goals with end-of-year performance projections
Simulate ‘what if’ analysis to incorporate influencing factors and provide optimal path to achieve Stars improvement
Recommend goals for Star score by incorporating business intuition
Take ROI driven decisions to improve Star ratings by optimizing improvement efforts
The FluidEdge Advantage
Our management consulting expertise together with CitiusTech’s platform capabilities uniquely position us not only to solve the payer challenge of improving their Stars scores but also bridge the gap between a MA plans business strategic priority and data-driven decision making for sustainable Stars improvement
Stars Service Offering
- Centralized platform for unified visibility into provider performance across various initiatives
- Stars Decision Engine: Performance projection and goal recommendations to enhance STARs ratings
- Developing a program roadmap, adhering to latest regulatory changes and assessing technology requirements across the organization
- Provider incentives & engagement: Periodic review of incentive provider incentive contracts
- Predefined health models, DM/UM/CM strategies, clinical system assessment/ implementation for clinical audits
- Providing operational support around interim leadership, project management & governance and staff augmentation
Consult our Professionals
Know more about our business consulting services and technology solutions.
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