The Covid-19 pandemic has had a sudden and far-reaching impact on Medicare Advantage Star Ratings. CMS will shortly publish 2021 Star Ratings including numerous adjustments for data that was not collected due to the pandemic.  CMS has also shared their plans for 2022 Star Ratings - how they will score the quality of care and service occurring in this unprecedented year.  In this post, Baltimore Health Analytics shares the key points of the communication and guidance from NCQA® and CMS regarding this year and what levers may still be pulled in the

Baltimore Health Analytics (BHA) is announcing the development of our Supplemental Data Source tool to assist health plans with raising HEDIS® rates. The tool utilizes medical records that health plans may have have in house. The BHA tool, known as Ocular, uses Optical Character Recognition (OCR) to allow scanning of medical records for keywords specific to HEDIS® measures. From there it is an efficient matching process to members with gaps, quick review and data validation and conversion in to a HEDIS® compliant Supplemental Data Source.

With the uncertain

BHA creates innovative tools for managing Star Ratings.  Our leading product, the Stars Planner is free to use and we just added our first video tutorial!

The Stars Planner is all about visualizing the way individual measure goals fit together to impact the plan’s Star Rating and CMS bonus.  It’s interactive -- start with published CMS star ratings data for your plan and your competitors -- then use it to figure out where to improve.  It keeps tally, shows historical trends, and allows experimentation with measure goals to get the best plan f

Introducing BHA’s Rover-Transitions.

When it comes to Stars and HEDIS®, health plans can’t always assume the network is addressing every gap in care.  Sometimes you need your own staff to work the phone to get the job done.  You can try to run a campaign from spreadsheets, or you can try to adapt an overly complex care management system that doesn’t really solve the right problem.  But if you want to maximize results with minimal effort, the best solution is a system that is designed specifically for the campaign yo

CMS is changing Star Ratings.  The Member Experience and Access categories are jumping from 1.5x to 2.0x this fall.  That’s significant, but the really big news in the Final Rule released on Friday May 22 (2020) is that they’ll be jumping again to 4x next year.  What will the impact of that move be?  Read on to learn more.