Hidden Impacts on Stars 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.

The difficulty of using the PHQ9 as the proxy for the HOS MCS measure is that it is primarily a measurement of clinical depression – an important assessment for Medicare beneficiaries, but one that does not delve in to driving factors that may lead to depression Seniors may face. Loneliness, isolation, and boredom have long been recognized as drivers of both poor physical and mental health, yet these issues are not truly addressed thru the PHQ9 tool.

In the age of Covid 19 loneliness and isolation have been exacerbated in ways not seen in society possibly ever. The impact on the health of Medicare members is profound, and health plans will need to rethink their strategy and interventions to address these issues, if for no other reason than the impact to their Star Ratings. I would very much like to hear the thoughts of the LinkedIn community related to this topic and thoughts on how health plans can be working with their membership on this issue.

Join the conversation at LinkedIn: https://www.linkedin.com/company/11518388/admin/