Bids for Medicare Advantage and standalone prescription drug plans have been submitted for the 2021 plan year. This was no small undertaking for health plans given the regulation changes from CMS and the COVID-19 pandemic. Unfortunately, the work does not stop as it’s now time to start planning for the 2021 plan year. For the Stars team, it’s important to work with Medicare accountable leadership to determine a budget for 2021.

In the budget planning process, keep in mind that 2021 initiatives will need to be different to account for the increased weight of member experience measures. As stated in my previous post on Star changes, it’s time to switch from campaign-based initiatives to continuous member engagement. What made plans successful in the past is not what will make plans successful in the future.

Collecting Member Sentiment

CMS announced that previous CAHPS results included in the 2020 Star Rating will be used for the 2021 Star Rating, which means plans are operating with member sentiment data from two years ago. For plans who implemented initiatives to improve the member experience, it’s unclear if these initiatives produced positive results. Now more than ever, plans need to collect member sentiment through a well-designed mock CAHPS survey. This data will provide crucial information to a plan regarding the member experience. From this information, plans can start implementing initiatives to improve the member experience for the 2021 plan year.

Importance of Partnerships

Traditionally, plans have relied on a mock CAHPS survey distributed through physical mailings and phone calls. These approaches are high-cost and inefficient, which limits the scalability of the mock surveys. As a result, most plans conducting a mock survey are only contacting a portion of their population. Transitioning to a digital survey distributed through digital communications are more scalable, efficient, and timely. With digital surveys, irrelevant questions can be suppressed based on member responses. This creates a better experience for a member as they don’t have to flip the paper survey pages to skip non-applicable questions. Additionally, digital surveys are scored and summed in real-time, allowing for greater outreach to a plan’s population and quicker delivery of information to the plan. This allows plans to implement a mock CAHPS tool that’s cost-effective and more efficient.

HealthMine is a thought partner and assists plans with executing a digital mock CAHPS survey. We can onboard a client in 60 days with minimal effort from health plan resources. Our solution can be connected through a web portal or mobile application on the member’s smartphone. As part of implementation, HealthMine’s communication package is reviewed with the clients, eliminating the need for our client to create custom communications. We also utilize a robust, multi-modal registration strategy to maximize the percent of a plan’s population interacting with our platform. This can also include support from our contact center, making outbound introductions to the program.

For more information on how to plug into the digital surge and improve member experience, feel free to contact me at james.haskins@healthmine.com.

 

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James Haskins is Director of Government Programs at HealthMine Inc. with 13 years’ experience in Healthcare Effectiveness Data Information Set (HEDIS), Medicare Star Ratings, Medical Record Review, and Data Analytics.