Driving Medicare Advantage Star Rating Success Through Collaborative Innovation

09/30/2024

CASE STUDY:

Local health plans are dedicated to providing high-quality care tailored to their members' needs. However, the evolving Medicare Advantage (MA) landscape presents growing complexities, such as CMS raising 70% of cut points and declining average plan ratings from 4.07 to 3.92. To address these challenges, the Health Plan Alliance (HPA) Medicare Advantage Stars Collaborative has become a critical resource for health plans striving to enhance their performance.

Program Highlights

The 2024 Medicare Advantage Stars Collaborative, supported with Star Rating experts from Healthmine, brought together 27 health plans to develop and implement data-driven strategies, benefiting from a collaborative environment built on trust, respect, and open communication. Participants tackled real-world challenges and explored practical solutions to improve Star ratings, positioning themselves for both immediate and sustained success.

Key Achievements

• Participant Feedback: The collaborative achieved an average satisfaction score of 9 out of 10, reflecting its substantial value and impact.
• Foundational Activities:
• Conducted comprehensive Stars opportunity self-assessments, identifying success metrics and barriers.
• Developed data-driven organizational assessments to support MA product growth.
• Applied the Plan-Do-Study-Act (PDSA) model for root cause analysis on Star challenges.
• Engaged in real-world benchmarking and peer learning, leveraging participant experiences and data.

Core Skills and Knowledge Gained

Participants left the program equipped with:

1. Strategic Insights: A deep understanding of barriers to achieving Star ratings and quality goals.
2. Practical Frameworks: Tools to design, test, and implement innovative plans for evolving challenges.
3. Future-Ready Strategies: Guidance for navigating transitions to digital quality measures, focusing on the Health Outcomes Survey (HOS), and advancing health equity.

Key Deliverables and Projects

Participants completed impactful projects, including:

• Stars Work Plan: Year-long strategic activity planning.
• HOS Playbook Development: Targeted strategies for improving HOS metrics.
• Member Engagement Work Plan: Enhancing outreach and engagement strategies.
• HEI Self-Analysis: Promoting health equity improvements.
• 2026 Strategy Report: Planning for sustained success.
• Stars Program Self-Assessment: Evaluating organizational processes and outcomes.

Looking Ahead

Building on the success of 2024, the 2025 Medicare Advantage Stars Collaborative will continue to empower health plans with strategic tools and peer collaboration opportunities, again supported with Star Rating experts from Healthmine to deliver expert guidance.

Key features of the 2025 program include:

• Quarterly Creative Labs: Addressing emerging challenges like transitioning to digital quality measures, implementing regulatory changes, and developing CAHPS and HOS strategies.
• Partner Expertise: Sessions supported with Healthmine's Star Rating experts, combining expert insights with peer learning in an interactive environment.
• Practical Application: Each lab provides actionable tools and frameworks for immediate implementation.
• Enhanced Collaboration: Four in-person sessions at the Alliance Learning Lab in Irving, TX, fostering deeper connections and shared learning among participants.

Conclusion

The Medicare Advantage Stars Collaborative has demonstrated the power of collective action, equipping health plans with the strategies, tools, and peer support needed to improve their Star ratings. As the collaborative enters its second year in 2025, participants will continue to adapt to evolving CMS requirements and advance their ability to deliver high-quality care. Together, Health Plan Alliance and Healthmine’s Star Rating experts are ensuring that local health plans remain a driving force in shaping the future of Medicare Advantage.