MA Plans Seek Ways to Improve Patient Experience, Stars

Last month marked the end of a three-month data collection cycle that will have a meaningful impact on the 2023 Medicare Parts C and D star ratings, when member experience measures take on a larger weight in star ratings calculations. While it’s too late to make a difference in how members responded to the recent Consumer Assessment of Healthcare Providers and Systems (CAHPS) that reflected the patient experience in late 2020 and early 2021, Medicare Advantage organizations should be focused on innovations that can prevent and resolve issues members face throughout the year to foster more positive feedback for future surveys, advises one longtime stars expert.

As numerous measures based on CAHPS and CMS administrative data move from a weighting value of 2 to 4 starting with measurement year 2021, the increased value of those measures will make up 32% of the overall 2023 star rating on a weighted basis. “We’ve always known member experience was important and we’ve always agreed we need to focus effort and attention in that area, but attaching such a heavy contribution to the overall star ratings to the surveys is the forcing function that most plans are seeing as the impetus for new actions,” says Melissa Smith, who is executive vice president of consulting and professional services at HealthMine, Inc., a Dallas- based member engagement firm.

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