The Quality STAR program rewards healthcare providers for delivering and coordinating preventive care for Medicare Advantage patients. This quality program is designed to drive continuous improvement in the quality of care that seniors receive. One of the ways that providers can demonstrate their achievement of Quality STAR measures is by submitting data on in-home assessments that are conducted using technology.
David Duel is an entrepreneur, philanthropist, and founder/CEO of the 400-person Medicare platform EasyHealth. EasyHealth focused on improving patient outcomes by combining insurance distribution and healthcare services. He said, “The annual gap measurement tracking, completion, and reporting process often requires significant oversight and investment to excel. This is why many providers would rather avoid the process entirely by going with a partner who is committed to simplifying and streamlining these measures.
David Duel continued, “We’ve been able to achieve success by leveraging technology and multi-modal patient care delivery in closing gaps for customers, allowing them to reach 4-5 STAR ratings.”
What is the Quality STAR Program & Why Should I Care?
The Quality STAR program was developed by the Centers for Medicare and Medicaid Services (CMS) to help health care providers improve their quality of care. The Quality STAR program is a statewide initiative that rewards healthcare providers for high performance in the areas of patient safety, care coordination, and population health.
As a medical provider, you should care about the Quality STAR program because it is an opportunity for you to earn recognition and financial incentives by reporting data that your organization already tracks.
Studies show that in 2021, 81% of patients enrolled in plans that are 4+ STARs. This means that as a medical professional, you have the ability to impact your patient attribution at a plan level by completing high-quality STAR measures.
Understanding and excelling in the Medicare Advantage STARs program is important for several reasons:
Improved health outcomes and reduced medical costs as a result of a preventive care approach have been demonstrated.
For coordinating and finishing preventive care for patients, health plan partners may give direct incentives.
For those who earn 4 or more STARS, there’s another avenue for attribution growth.
How EasyHealth Deploys Tech-Enabled In-Home Assessments to Support 4+ STAR Performance
David Duel also said, “If patients have trouble making it to the office to complete their regular wellness checks, in-home assessments are a great way for you to increase your patient wellness check completion rates.”
If there is a lack of capacity, scheduling availability is impossible, or your patients are refusing to visit the clinic, in-home assessments are a great way to remedy these problems.
Patients who go unscreened every year have lower Quality scores and drag down an organization’s overall quality performance, so it’s crucial for your practice to screen as many people as possible.
EasyHealth Process and Implementation Considerations:
The most important part of the protocol is to be able to identify what measures are required in each domain (patient experience, safe and well-coordinated care, and healthy living) as well as the measures that drive performance in your contracts. Assess for Quality performance gate to achieve or share in shared savings with health plan partners.
To ensure overall integration, software systems must be reviewed and improved. Closing the quality measurement loop necessitates process management and oversight across various workflows, such as medication adherence, kidney function testing, and colorectal cancer screening. It is critical to have an EHR system or practice management system that may track activity outside of a clinical visit in order to keep track of completion throughout each phase of each quality measure.
Consider using automated data feeds and data gathering. When possible, connect with an EMR system via third-party centers, vendors, labs, and other data sources.
This article is only a high-level summary, and every medical practice has different needs and considerations for recording and capturing Quality indicators. Individualized assistance will ensure your success with reporting.
For further reading about EasyHEalth see: EasyHealth, a startup targeting the Medicare experience, announces $135M Series A