McKinsey October 15, 2020
Stephanie Carlton, David Malfara, Kevin Neher, and Cara Repasky

Although customer experience measures have been a component of Stars ratings for years, health plans have not been as successful in improving their customer experience compared to other industries.

When the Centers for Medicare & Medicaid Services (CMS) changed the methodology for calculating Medicare Advantage (MA) quality scores in May 2020, it meant customer-experience-related metrics would determine 57 percent of overall Stars ratings (up 25 percentage points) by 2023.1 MA plans have long been accountable for quality performance, with roughly $15.1 billion in Stars-linked incentives creating a performance imperative. Excellent customer experiences will be even more critical moving forward. An analytics-driven approach to customer experience redesign could ensure Stars performance, while potentially driving growth for plans. Additionally, it could materially improving...

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2020-10-19T23:06:28-04:00