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The CMS Star Ratings program is a critical benchmark for Medicare Advantage plans, dramatically influencing member enrollment and reimbursement rates. With the introduction of the Health Equity Index (HEI) and other evolving measures, achieving high Star Ratings means staying ahead of this potentially dangerous.

Why Choose Icario for Star Ratings Improvement?

Icario leverages data from literally millions of member touchpoints, advanced behavioral insights, and our proprietary engagement platform to drive meaningful improvements in Star Ratings. Our personalized, data-driven approach ensures high engagement rates, closes care gaps, and enhances member satisfaction. As a result, health plans partnering with Icario experience a tremendous boost in performance and improved member satisfaction rates. performance.

Comprehensive Data Utilization

Icario leverages extensive member data to provide actionable insights that improve Star Ratings. By identifying key areas for improvement and tailoring interventions to specific member needs, we help enhance a health plan’s performance across every measured category.

Integrated Engagement Strategies

Icario’s proprietary engagement platform integrates advanced analytics with personalized communication strategies to optimize member outreach. By focusing on whole person data, we create effective engagement plans that drive better health outcomes and improve Star Ratings.

2024 Star Ratings Summary

This Year’s Key Performance Changes:

  • Tukey Outlier Deletion: Reset cut points for every measure, stabilizing overall ratings. This change led to a significant drop in average Star Ratings.
  • CAHPS Adjustments: Weights reduced from 4 to 2, emphasizing the importance of clinical measures over member experience alone.
  • New Star Ratings: Introduction of measures for Plan All-Cause Readmissions, Transition of Care, and Follow Up for Emergency Department Visits for High-Risk Chronic Members, focusing on reducing readmissions and improving post-discharge care.

Future Considerations to Stay Ahead of the Curve

  • Annual Flu Vaccine Changes: Transition from CAHPS-based performance to actual claims data.
  • Controlling Blood Pressure: Increased emphasis on accurate data capture and coding.
  • Kidney Health Evaluation for Diabetes: New requirement for both blood and urine tests.
  • Quality Improvement – Removal of Hold Harmless: Only 5-Star plans can exclude negative scores.
  • Digital Experience in CAHPS: Introduction of digital surveys to better capture member feedback.

For detailed updates on the 2024 Star Ratings, read our full breakdown of the 2024 Medicare Star Ratings release.