Jeff has spent 20 years as a software developer, architect, analyst, and as a health plan leader. He is our resident expert on Star Ratings - from analysis and strategy to reporting, data and algorithms. in
|Phase 1||Phase 2||Phase 3||Phase 4|
Evaluate your current Star Ratings.
Triage measures to set realistic goals for each.
Drill into the Part C and Part D Improvement scores.
Inventory the tools, skills, systems and processes in place and needed for Stars.
Trace the flow of stars related data through your organization.
Chart a path to 4 Stars.
Prioritize the changes needed to get there.
Develop a long range vision for your stars operations.
Assess each existing process in detail to determine what is needed to optimize it for Stars.
Plan Create a detailed project plan for how to
Design the reporting regimen and controls that are appropriate for the organization and culture.
Actively look for quick fixes and minor adjustments for immediate relief as an integral part of this phase.
Build the tools and systems. Tasks vary based on need.
Deploy vendors as needed.
Train and recruit staff to build out internal capabilities.
Start new clinical interventions.
Create data warehouses, systems, data exchanges, targeting criteria, reports and dashboards.
Optimize existing processes.
Implement reports, procedures and dashboards to monitor Stars.
Get to a steady-state where higher performance is the new normal and part of the plan's culture.
Our 4 step approach can be tailored your specific needs. It all stars with a rapid initial evaluation that includes an analysis of scores, comparison of each measure to to peer averages with benchmarks, review of score and threshold trends, analysis of the 5x weighted improvement measures, and a review of current systems, interventions, targeting criteria, timeliness, data and operations.
Our goal is to get in and out with the evaluation as quickly as possible. To achieve that, Baltimore Health Analytics developed a "Stars Cookbook" that facilitates the review of your plan. This cookbook includes report templates, references, tips, powerpoint templates, and structured interview instruments for each area of your stars operation and strategy.
Some plans just need the evaluation report to accelerate their own internal quality improvement efforts. Others want our help planning and building out their Stars analytics and infrastructure. We will leverage your existing strengths and supplement it with our end-to-end strategic, analytical and technical skills.
|Create real-time medication adherence tracking. Devise strategies that address data quality, timing, and measure quirks.||Apply analytics to your HEDIS® chart chase. Make sure your team is going all out for the members, providers and measures where there is still an opportunity to improve scores.|
|Assign members to clinical campaigns. Automate eligibility lists for prioritizing members by likely differential impact and per member next best action.||Collate member and provider contact information across enrollment, claims, clinical and other systems to determine the most up to date, second best, etc.|
|Turn your claims and enrollment data into a robust clinical data warehouse.||Create dynamic member eligibility for you clinical intervention strategy.|
|Build daily updated quality measures eligibility and numerator tracking into your existing datawarehouse. Create proxy measures from available data.||Create a daily/weekly admission tracking dashboard with trends by condition and source of admission.|
|Build out automated dashboards for clinical trends including costs, hospitalizations and readmissions.||Deep dive into your "potentially avoidable hospitalization" data to identify trends,causes and risks.|