Ask Me Anything: Q&A with Star Ratings Leaders

For the third and final session of the 2022 Star Ratings Webinar Series, Healthmine hosted a live “Ask Me Anything”-style webinar. In this 90-minute question and answer session, Healthmine’s EVP of Consulting Melissa Smith and members of her team answer a wide range of pre-submitted and live questions from audience members throughout the series.

In addition to providing research-backed guidance about regulatory and technical updates, the presenters also gift participants with some of their well-educated guesses, or “crystal-ball” predications, for the future of Star Ratings.

The group stayed on well past the scheduled hour to answer questions in the following categories (among many more!):

• Advancing Racial Equity & Support for Underserved Communities:
  • What should plans know about Executive Order 13985 (Advancing Racial Equity & Support for Underserved Communities) requirements, especially now that it has been escalated to page one of the 2022 CMS Medicare Advantage Readiness Checklist?
  • What are the best practices for Stars teams to collaborate with other internal resources including HR, community relations, and compliance in order to advance health equity?
• Transitions of Care (TRC) and Follow-Up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC) Process Measures:
  • How will the TRC measure be reported back to payers? Are CPT II in play or could it be through supplemental data submission?
  • How does the "measure math" work on TRC?
  • Will TRC be considered as a process or an outcomes Star measure?
  • Is there any indication that one of the TRC indicators may be weighted higher than other indicators?
  • For notification of admission, if a patient indicates that they have not seen a practitioner in 20 years, how is that notification reconciled?
  • For telephonic outreach, would a call from an appointment desk count towards meeting the measure?
  • Which provider types and services qualify for the FMC technical specifications?
• New Cut Point Guardrails:
  • What is the difference between the cut point guardrails and the Tukey outlier deletion? What is their impact on the cut points in the coming years?
• Rewards & Incentives Program Guidelines:
  • With the new ruling around incentives, do health plans need to "actively promote" the availability of incentives to all eligible members?
  • Can plans wait until a member calls to request an award (versus automatically dispersing the reward) if they are outside of the HEDIS® criteria?
  • Where can plans find the most updated memos regarding the Rewards & Incentives ruling?
• Predictions & Indications of Future Measurement Changes:
  • Are the HOS measures of Risk of Falls & Bladder Incontinence going to change in the next couple of years?
  • Is there any indication that Care for Older Adult (COA) Functional Assessment will come back out of display for Stars 2024?
  • Is Osteoporosis Screening in Older Women (OSW) replacing Osteoporosis Management in Women Who Had a Fracture (OMW) as a Star measure for 2024?
  • Are there any changes proposed for Statin Use in People with Cardiovascular Disease?
  • Were the drastic number of changes in the reward factor calculation values (including performance summary thresholds and variance thresholds) specific to the 2022 Star Ratings, or will the trend continue for future years?

To round out the conversation, Melissa, Cynthia, and Dwight share the key components that should be included in any presentation to executives regarding Stars strategy. If you’re looking to master new measures and ensure your team has allocated the proper resources to achieve your Star Ratings goals, this is a webinar you don’t want to miss. Fill out the form to watch a replay of this session.