Leveraging Data to Boost Star Ratings Performance: Three Steps to Building and Operating an Exceptional Program

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In the Medicare Advantage market, Star Rating performance impacts a health plan’s bottom-line profitability and shapes consumer perceptions. Achieving and maintaining exceptional Star Rating performance is becoming increasingly difficult due to rising CMS standards, higher consumer expectations, and a shift in emphasis toward scores in more ambiguous categories like member experience. This paper describes the roadblocks health plans face and the characteristics of a successful program built on robust data collection and analysis. Specifically, it outlines the concrete steps plans can take to assess member and provider performance, enhance engagement and alignment, implement effective outreach and engagement strategies, and drive improvements in organizational learning and program excellence year over year.

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