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Hidden Impacts on Stars HOS Ratings

Posted By: Kathy Lester  On : November 17 2020
Hidden impact on star hos ratings

Improving or Maintaining Mental health (MCS) is an important triple weighted HOS measure in the Star metrics, yet it is difficult measure for health plans to measure outside of the annual HOS season, or to move the rating upwards. We’ve often seen health plans respond using standard screening tools for mental health.  In particular the PHQ9 is often used as the first entry point into managing mental health.  The PHQ9 is a 9 quick question screening, the intent is to have the point of care provider screen members and then coordinate services for the member as appropriate.

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Hidden Impacts on Stars HOS Ratings

Posted By: Kathy Lester  On : November 17 2020
Hidden impact on star hos ratings

Improving or Maintaining Mental health (MCS) is an important triple weighted HOS measure in the Star metrics, yet it is difficult measure for health plans to measure outside of the annual HOS season, or to move the rating upwards. Many health plans ask providers to use as a proxy for the measure the PHQ9, a screening tool used at the point of care. Based on the scoring of this tool, the intent is to have the provider coordinate services for the member as appropriate.

 

 

The difficulty of using the PHQ9 as the proxy for the HOS MCS measure is that it is prim

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Posted By: Kathy Lester  On : November 17 2020
Hidden impact on star hos ratings

Improving or Maintaining Mental health (MCS) is an important triple weighted HOS measure in the Star metrics, yet it is difficult measure for health plans to measure outside of the annual HOS season, or to move the rating upwards. Many health plans ask providers to use as a proxy for the measure the PHQ9, a screening tool used at the point of care. Based on the scoring of this tool, the intent is to have the provider coordinate services for the member as appropriate.

 

 

The difficulty of using the PHQ9 as the proxy for the HOS MCS measure is that it is prim

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YOY Star Ratings Changes

Posted By: Curt Narvesen  On : November 06 2020
Yoy star ratings

CMS recently released their 2021 CMS Stars ratings data. Were there more plans and contracts whose ratings declined since last year? Or was there a significant increase in scores?

 

 

The largest five Medicare organizations are comprised of 122 Contracts. Comparing the results between 2020 and 2021, 8 of these contracts increased their overall STAR rating by ½ point, 73 contracts remained the same, and 31 decreased by ½ point. 

 

 

The 129 smaller organizations are made up by 256 Contracts. Of these contra

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Advance Notice from CMS of Stars Methodological Changes 10/30/20

Posted By: Curt Narvesen  On : November 06 2020
Cms of stars methodological changes

On Friday, October 30, 2020 CMS released an Advanced Notice of Methodological Changes for Calendar Year 2022 for Medicare Advantage Capitation Rates and Part C and Part D Payment Polices – Part II. Of note in this release there is updated information on two HEDIS measures that will be of interest to Stars and HEDIS managers. These HEDIS measures have had significant changes in how they are collected, such that they are now on the Stars display page.

 

 

Controlling High Blood Pressure – In July 2020 NCQA announced a substantive c

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