Maximize End-of-Year Performance

The fourth quarter is critical to securing the highest possible quality scores and bonus payments. According to Mallory Mueller, Vice President of Population and Equity, “Effective year end success relies on strategic, fast and targeted gap closure. There’s not a lot of time left, so prioritization is key.” 

Our experts in Star Ratings, quality improvement and member experience joined forces to share their insights into 2024 performance so far and what plans need to do to level up before the end of the year.

Presenters:

• Mallory Mueller, Vice President of Population Health and Equity
• John Willis, Vice President of Consulting and Professional Services
• Chris Gage, Director of Product and Experience Strategy

Key takeaways:

• Star Ratings cut point changes means plans need to reassess their goals and intervention strategies while they can still influence Stars Year (SY) 2026. About 70% of cut points increased, causing concern for plans. In addition to covering upcoming measure changes in Stars, presenters provided tips and tricks on what it takes to be successful.
• Plans need to coordinate efforts across internal teams to not have members feel caught in the crosshairs of differing team priorities which can create confusion, abrasion and lack of action.
• The value and importance of compliant, coordinated member outreach. This helps members guide gap closure and improves member retention, experience and optimizes resources. Understand how the effort to better coordinate outreach can translate to plan performance, Stars scores and CAHPS scores.
• Understand the value of surveying and the importance of using member responses. For most members, not acting on member input will cause more abrasion than not asking in the first place. Quick surveys, like Pulse Surveys, can help assess member needs and sentiment fast so plans can apply the data when it matters most.
• How behavioral science can drive member action throughout the year, especially in Q4. This is the best time to leverage urgency in member messages, encouraging members to close gaps and not miss out on rewards, or by offering recognition for completed activities to improve satisfaction and retention.
• How an omnichannel approach can help plans reach all types of members with varying care gaps and reduce expenditures. Omnichannel methodology is just one step towards improving member personalization. As plans layer in preferred languages and what motivates members, plans can improve experiences and build member trust.
• Hear an example strategy for an EOY push to close critical care gaps and how plans can use multiple outreach methods in tandem to get the best results.
• What and how to get started in Q1 2025 to start the year successfully and set the stage for meeting plan goals and avoid or minimize a Q4 push next year.

Reach out to us to develop a smart Q4 strategy while there’s still time.