CMS’ Star Ratings

At MindfulRx, we leverage our expertise in medication management to support health plans in improving their CMS Star Ratings. Through targeted interventions, we focus on critical areas such as adherence to medications for diabetes, hypertension, and statins, which have a direct impact on Star Ratings. We also address newly weighted measures, including the concurrent use of benzodiazepines and opioids, among others. Our goal is to enhance patient outcomes while boosting the performance metrics that drive a plan's Star Ratings.

With our deep knowledge and experience in the CMS Star Rating Program, we continuously monitor changes in the program to stay ahead of evolving requirements. This allows us to identify display measures that have the potential to convert into weighted measures to develop initiatives aimed at improving performance in these areas.

Our programs involve collaboration with patients, providers, community pharmacies, prescribers, and medical groups. We work with our clients to develop strategies that align with the specific needs of their populations. These customized initiatives aim to address both adherence challenges and emerging measures in order to improve overall plan performance.

By focusing on evidence-based interventions and maintaining close communication with key players, we aim to improve patient outcomes and contribute to better Star Ratings for health plans.

Reference:

1. Centers for Medicare & Medicaid Services. (2023). 2024 Medicare Advantage and Part D Star Ratings. Retrieved from https://www.cms.gov/newsroom/fact-sheets/2024-medicare-advantage-and-part-d-star-ratings

2. Centers for Medicare & Medicaid Services. (n.d.). Five-Star Quality Rating System. Retrieved from https://www.cms.gov/medicare/health-safety-standards/certification-compliance/five-star-quality-rating-system