Medicare Part D STAR Rating Changes, Total Therapeutic Management's Action Plan for Health Plans
Total Therapeutic Management, Inc. (TTM) hosted its second webinar in their complimentary webinar series: Reaping the Rewards of Quality Improvement. This second webinar in the TTM series focused on Medicare Part D STAR Ratings Improvement and was presented by nationally recognized Medicare STARS expert, Mitzi Wasik, Pharm.D, Director of Medicare Programs at Coventry Healthcare1. The webinar highlighted the recent changes to the Medicare Part D STAR Ratings released by CMS on September 9, 2012 and the actions health plans can take to adjust to these new measures, while addressing new and existing barriers to achieving quality improvement goals.
The session was moderated by Barry Patel, Pharm.D, President and Co-Founder of TTM. Dr. Patel noted that the topic was timely because as quality and outcomes become increasingly quantifiable through programs such as Medicare STARS, healthcare organizations have to prepare themselves with the knowledge related to changes and subsequently implement appropriate member and provider engagement strategies.
Dr. Wasik's keys to implementing strategies for STAR ratings improvement:
Apply a “top-down” team approach.
|Dr. Wasik explained success is most often experienced when careful coordinated planning includes objectives and commitment from the health plan (top), down to engagement and education of the provider and the patient.|
Understand, engage and educate your team.
Understand the providers' practice environment. For example: providers are inundated with plan provided outreach, such as fax campaigns and letters, which often don't get into the right hands.
|Understand your beneficiaries - they are not all created equal. A 65-year-old does not have the same needs or patterns as a 75-year-old that has been regularly using the system.|
|Engage providers with useful and relevant information to understand their performance gaps. Health plans using Acumen data alone will not fully understand their performance gaps – by the time the health plan views their Acumen data, it is at least a month old if not more.|
|Educate your team. Thoughtful education of providers reinforcing the quality improvement objectives will complete the “top down approach” and achieve better outcomes for the patient, resulting in STAR ratings improvement.|
Embrace the challenge.
“Triple-weighted measures are making a significant impact when we are looking at our Quality Bonus Payments (QBP) so extra resources are required to move the needle,” says Dr. Wasik. “Be prepared to invest in resources, time and energy.”
TTM offers data-driven provider outreach services to some of the nation's largest health plans and continues to work with Medicare Advantage Health Plans to determine where provider outreach may boost their Star Ratings. TTM will continue its quarterly “Reaping the Rewards in Quality Improvement” series with the next session to be held in January. More information is at www.rxttm.com.
TTM (Total Therapeutic Management, Inc.) is a unique healthcare provider focused, Quality Improvement Company that provides outcomes research and clinician engagement services for some of the nation's largest healthcare organizations, including the Federal Government. Today, TTM maintains two very unique core competencies within the Healthcare Services Industry: Abstraction and aggregation of medical chart data to support outcomes research and quality improvement projects; A unique ability to engage physicians for one-on-one educational outreach, helping health care organization clients realize their quality improvement goals. TTM has successfully implemented projects in various disease states with over 130 managed care plans and 50,000 physician offices nationwide. Since 1995, TTM is the company healthcare organizations have relied on to improve quality through its core mission of better information…better outcomes. For more information, visit www.rxttm.com.
1 Dr. Mitzi Wasik spoke only on her personal opinion and was not speaking on behalf of Coventry Healthcare.