HEDIS® measures have long been the focal point of the Star Rating Program for Medicare Advantage. The Centers for Medicare & Medicaid Services (CMS) is constantly making changes to the program, to stay current with patients’ needs, these adjustments have a direct correlation with the expectations from providers in order to have a strong performance in HEDIS®-based measures and achieve a 5-Star Rating plans and providers have to comply with HEDIS® requirements.
Often the Health Plans strategy to improve HEDIS® performance IS through multiple campaigns and member touches. In recent years, plans have transitioned to consolidated communications to address all HEDIS® gaps for a member. However, the approach, even in a consolidated communication plan, remains campaign based.
While campaign-based strategies have worked to improve HEDIS® performance, this strategy is less likely to be effective in addressing member experience, and now CAHPS® surveys are having a higher weight in start rating performance.
CMS has made clear that member experience is a high priority, moving CAHPS® to a 4x weight HEDIS®. This weight change will give patient survey results a strong and significant percentage of the Stars Ratings program.
With these important changes, it is critical that providers collect member satisfaction throughout the year, by conducting a mock survey, Healthcare providers can collect data that allows them to sight into prospective areas of improvement for member experience. CAHPS is becoming the focal point of the Stars Program, and strategic actions will allow organizations to implement initiatives to improve the member experience and its overall patient satisfaction survey score. Ensure Data Solutions, Service Assessment module, have the capability to conduct mock surveys in order to assess the patient experience.
Evaluating patient experience data in advance would be the key to success, Ensure Data Solutions facility this process via pre-set questions and visible real-time results, giving physicians the opportunity to address concerns and assess areas that need improvement. To learn more about how Ensure can help call 786-551-1456 or email info@ensuredatasolutions.com.
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