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Actionable Strategies to Support Health Plans’ Year-End Push for Performance Gains

The fall release of CMS Medicare Advantage and Part D Star Ratings data signals health plans’ last opportunity to make improvements before the end of the current measurement year impacting 2021 ratings. From October to December, plans can make one final proactive push to close care gaps and boost performance.

The five-star quality ratings system reflects how well a health plan meets member needs and federal recommendations on patient care. Performance ratings, which are publicly published on, influence consumer perception of health plans and have a direct impact on the plan’s member enrollment, revenue and potential to earn bonus incentives.

A one-star higher rating has been associated with a 9.5% greater likelihood of member enrollment, according to the American Medical Association.

BioIQ’s latest eBook, Five Ways to Move the Needle on Quality and Boost Star Ratings Before Year End, sheds light on tactics health plans can employ to quickly and successfully achieve star ratings improvements. This includes recommendations on ways plans can leverage data and analytics to develop a laser-focused strategy that homes in on the quality measures and member populations with the greatest potential to drive ratings gains.

The eBook also offers advice on how health plans can design member outreach programs to drive swift action. By developing messaging designed to appeal to specific patient personas, plans stand a greater chance of cultivating member follow-through to support meeting health objectives. Digital engagement solutions, retail-based offerings and direct-to-consumer health testing programs play a key role in meeting these goals.

Aligning quality improvement programs to member lifestyle factors improves gap closure rates as well as the member experience. Tapping into innovative ways to engage members in their preferred manner can also motivate provider engagement in improvement initiatives. Diverse member engagement options enable provider support without additional burden to clinicians. Member outreach initiatives co-branded by both their health plan and their provider fare greater chances of driving desired health actions.

According to Alvonice Spencer, BioIQ’s Senior Innovation Director, “With the window to influence ratings closing, the time for health plans to take action is now. Plans with bonus payments, member enrollment and revenue at stake should develop a targeted strategy that will yield maximum results in the diminishing time left to improve ratings performance.”

Spencer encourages health plans with limited time and resources to seek strategic partners to help get year-end initiatives over the finish line. “Engaging third-party partners with expertise in member engagement and quality improvement programs can alleviate internal staff burdens and bring dedicated focus to efforts so health plans can achieve big gains in a short amount of time.”

Download the free eBook here to support your star ratings improvement strategy and register for our complimentary webinar, “Last Mile Push: 5 Ways to Boost Quality Ratings” on Oct 17 at 1 pm ET to learn more.

Webinar - Last Mile Push: 5 Ways to Boost Quality Ratings

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