The 2025 Star Ratings results means substantially fewer Medicare members are enrolled in 5-star plans. Our team of stars experts led a two-part webinar series to dig into the data and identify trends in the results and facilitate thoughtful strategy development as Medicare plans head into the next measurement year.
Presenters:
- Mallory Mueller, Vice President of Population Health and Equity
- Ana Berridge, Executive Advisor, Consulting & Professional Services
- Dwight Pattison, Executive Advisor, Consulting & Professional Services
Key takeaways in part one:
- The highlights and lowlights of Medicare Star Ratings performance.
- What hurt plans this year and how those factors will come into play in the next scoring year, including the ongoing impact of Tukey over the next several years.
- What helped plans and prevented a bigger drop in ratings, an important consideration in knowing what could negatively impact plans in forthcoming scoring years.
- Drivers of Special Needs Plans (SNP) performance.
- Cut points for specific measures and what that tells us about plan operations and performance.
Key takeaways in part two:
- Specific measure overviews, including how scoring for these measures are changing next year and how plans can continue to improve on them.
- How to address member dissatisfaction and identify which populations you're probably not reaching out to enough, how to get in touch with them and why.
- How to move forward with new Part D measures for SY27.
- Which measures are returning and how to effectively address them.
2025 Star Ratings: Unpacking the Data Part One
The 2025 Star Ratings results means substantially fewer Medicare members are enrolled in 5-star plans. Our team of stars experts led a two-part webinar series to dig into the data and identify trends in the results and facilitate thoughtful strategy development as Medicare plans head into the next measurement year.
Presenters:
- Mallory Mueller, Vice President of Population Health and Equity
- Ana Berridge, Executive Advisor, Consulting & Professional Services
- Dwight Pattison, Executive Advisor, Consulting & Professional Services
Key takeaways in part one:
- The highlights and lowlights of Medicare Star Ratings performance.
- What hurt plans this year and how those factors will come into play in the next scoring year, including the ongoing impact of Tukey over the next several years.
- What helped plans and prevented a bigger drop in ratings, an important consideration in knowing what could negatively impact plans in forthcoming scoring years.
- Drivers of Special Needs Plans (SNP) performance.
- Cut points for specific measures and what that tells us about plan operations and performance.
Key takeaways in part two:
- Specific measure overviews, including how scoring for these measures are changing next year and how plans can continue to improve on them.
- How to address member dissatisfaction and identify which populations you're probably not reaching out to enough, how to get in touch with them and why.
- How to move forward with new Part D measures for SY27.
- Which measures are returning and how to effectively address them.
Speakers
Mallory has over 15 years of leadership, quality and clinical experience delivering 5-Star quality care for senior populations in managed care plans and assisted living settings. She previously served as the Director of Quality Health Integration at Network Health Plan where she oversaw all regulatory programs and led the plan to achieve 5-Star performance. Mallory is a Registered Nurse and earned her BSN from the University of Wisconsin-Green Bay.
Ana brings more than 20 years of healthcare and health plan experience to Healthmine. She most recently came from WellSense Health Plan, formerly Boston Medical Center HealthNet Plan. She had oversight of work related to Stars, HEDIS®, NCQA, Quality Rating System, External Quality Review Organization, population health programs, new product implementation, value-based care programs, policy advocacy and health equity programs.
Ana developed multiple innovative member and provider interventions that were integral in the successful improvement of key HEDIS and Consumer Assessment of Healthcare Providers and Systems (CAHPS) quality measures and meeting corporate and contractual goals. She has experience with successfully identifying and implementing new to industry initiatives, such as texting, with proven quality and financial improvement. Ana is bilingual in English and Spanish and has used this in community initiatives to help engage members and improve the quality of care for the Medicaid, Medicare, Affordable Care Act, and Commercial populations.
Ana holds a master’s degree from Simmons University in Health Administration and a bachelor’s degree from the University of New Hampshire.
Dwight Pattison is a consultant with over twenty years of healthcare industry experience focused on quality management, performance improvement, data analytics, and reporting. Fueled by a strong background in Medicare and Medicaid reporting and regulatory compliance, Dwight has directly led MCOs in achieving significant performance improvement results across numerous markets and product lines.
2025 Star Ratings: Unpacking the Data Part One
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The 2025 Star Ratings results means substantially fewer Medicare members are enrolled in 5-star plans. Our team of stars experts led a two-part webinar series to dig into the data and identify trends in the results and facilitate thoughtful strategy development as Medicare plans head into the next measurement year.
Presenters:
- Mallory Mueller, Vice President of Population Health and Equity
- Ana Berridge, Executive Advisor, Consulting & Professional Services
- Dwight Pattison, Executive Advisor, Consulting & Professional Services
Key takeaways in part one:
- The highlights and lowlights of Medicare Star Ratings performance.
- What hurt plans this year and how those factors will come into play in the next scoring year, including the ongoing impact of Tukey over the next several years.
- What helped plans and prevented a bigger drop in ratings, an important consideration in knowing what could negatively impact plans in forthcoming scoring years.
- Drivers of Special Needs Plans (SNP) performance.
- Cut points for specific measures and what that tells us about plan operations and performance.
Key takeaways in part two:
- Specific measure overviews, including how scoring for these measures are changing next year and how plans can continue to improve on them.
- How to address member dissatisfaction and identify which populations you're probably not reaching out to enough, how to get in touch with them and why.
- How to move forward with new Part D measures for SY27.
- Which measures are returning and how to effectively address them.
Featured presenters
Mallory has over 15 years of leadership, quality and clinical experience delivering 5-Star quality care for senior populations in managed care plans and assisted living settings. She previously served as the Director of Quality Health Integration at Network Health Plan where she oversaw all regulatory programs and led the plan to achieve 5-Star performance. Mallory is a Registered Nurse and earned her BSN from the University of Wisconsin-Green Bay.
Ana brings more than 20 years of healthcare and health plan experience to Healthmine. She most recently came from WellSense Health Plan, formerly Boston Medical Center HealthNet Plan. She had oversight of work related to Stars, HEDIS®, NCQA, Quality Rating System, External Quality Review Organization, population health programs, new product implementation, value-based care programs, policy advocacy and health equity programs.
Ana developed multiple innovative member and provider interventions that were integral in the successful improvement of key HEDIS and Consumer Assessment of Healthcare Providers and Systems (CAHPS) quality measures and meeting corporate and contractual goals. She has experience with successfully identifying and implementing new to industry initiatives, such as texting, with proven quality and financial improvement. Ana is bilingual in English and Spanish and has used this in community initiatives to help engage members and improve the quality of care for the Medicaid, Medicare, Affordable Care Act, and Commercial populations.
Ana holds a master’s degree from Simmons University in Health Administration and a bachelor’s degree from the University of New Hampshire.
Dwight Pattison is a consultant with over twenty years of healthcare industry experience focused on quality management, performance improvement, data analytics, and reporting. Fueled by a strong background in Medicare and Medicaid reporting and regulatory compliance, Dwight has directly led MCOs in achieving significant performance improvement results across numerous markets and product lines.
