Deep Dive: Themes from 2023 Star Ratings and Changes Coming

Watch the most recent Stars webinar.

After an unpredictable Star Ratings release, there were many questions and concerns related to 2023 overall ratings, specific measurements, and how plans should move forward.

Following our Q&A: 2023 Star Ratings and Beyond webinar, we held Deep Dive: 2023 Star Ratings and Beyond to discuss the final Star Ratings more in-depth. Our Star Ratings experts put their brains together to provide insight, cautionary tales, and next steps for MA plans. Hear from:

• Melissa Smith, Executive Vice President, Consulting & Professional Services
• Kimberly Swanson, Senior Vice President, Consulting & Professional Services
• Dwight Pattison, Vice President, Consulting & Professional Services
• Cynthia Pawley-Martin, Senior Consultant, Consulting & Professional Services

There was one key takeaway: change is coming. The team unpacked a long list of confirmed and suspected regulatory updates on the horizon. “We have never seen so much change,” says Smith. “CMS knows Star Ratings through Medicare Advantage is their lever to make change.”

Here are a few ways health plans will be seeing change soon. Access the on-demand webinar for more examples of how the industry is changing sooner rather than later, and detailed insight from our industry experts on how your plan can move forward with success.

2023 Star Ratings Themes

Following the pandemic-led spike in the average Star Ratings in the previous year, this year was humbling for many health plans. Identify where the averages fell for 2023 and the calculations that led to those averages by getting answers to the following questions:

• How did 38 unique measures rated in 2023 impact overall Star Ratings?
• How did varying weighted measures play into the final ratings?
• What measurements should analytics teams focus on to identify statistical improvement?
• How did different types of plans fare in the final ratings?
• How does plan maturity play a role in overall ratings?

Surveying Members

Member experience needs to be looked at holistically. Moving forward, leveraging the Consumer Assessment of Healthcare Providers and Services (CAHPS), the Health Outcomes Survey (HOS), Health Risk Assessments (HRA), and provider monitoring will be key to understanding the member experience and how to improve it.

“It’s not just doing one mock-CAHPS survey or doing multiple surveys on one or two issues,” says Swanson. “It’s about continuously checking in with your members.”

Download Healthmine's CAHPS Playbook which guides Medicare plans throughout the year to keep a continuous focus on CAHPS improvement and deploy the right strategies at the right time.

Health Equity

The Health Equity Index is coming as early as measurement year 2023 so plans can start showing CMS that they are actively working to remove barriers to care for all members.

“CMS is emphatically focused on the patient and reducing disparities,” Smith says. “They’re using quality as the anchor for the care journey and as the impetus for all the change.”

But what does that tactically mean for health plans? The tools and dashboards being leveraged will play a vital role in success within the Health Equity Index. Use surveying tools with all members to identify barriers to care, transportation, housing and food insecurity.

Smith emphasizes that different MA contracts will require different tactics to zero in on health equity measures.

The Expert Advisory Services team have worked in Stars since the program was first launched and gone through several years of change while guiding health plans toward success. Access the on-demand webinar to learn more about their key takeaways from this year’s ratings, strategies for tackling change, how to take on the right Math Path to ensure success, and the first five steps plans should take.