Managed Healthcare Executive January 25, 2021
Optimizing your Star Rating program with machine learning technology.
Health plans have been working to optimize their performance with the Centers for Medicare & Medicaid Services (CMS) Star Rating Program for years. Organizations that prioritize Star Rating improvement tend to develop better processes, meet member needs more effectively, and increase member recruitment and retention — all of which can boost financial performance.
However, improving a Star Rating is not a trivial undertaking. The dynamic and complex nature of the evaluation criteria often makes planning tricky. The measures on which a health plan is scored, the weights assigned to each measure, and the cut-points used to calculate the score may change from year to year. Adding to the complexity...
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