On May 23-24, RISE held its successful “Star Ratings Leadership Summit” in Chicago. We were fortunate to have Liz Goldstein, Director, Division of Consumer Assessment & Plan Performance at CMS, join us via web to discuss the Star Rating Program. Here are a few highlights of Liz’s presentation concerning the future direction CMS is taking in the Star Ratings.
Liz emphasized that future development of ratings will be aligned with the IOM’s six arms for improving healthcare delivery: i.e., safe, timely, effective, efficient, equitable, and patient-centered. She also said that CMS is going to look towards consensus-building organizations for the development of measures and clinical criteria.
Potential addition measures for 2012 plan ratings include:
1. All-cause readmission rates
2. Advising smoker and tobacco users to quit
3. Body mass index
4. SNP-specific measures
5. Voluntary disenrollment rates
6. Measures from the Hospital Inpatient Quality Reporting program
7. Part D transition process implementation
8. Part D medication adherence
And she mentioned these potential enhancements to the 2012 ratings:
1. Weighting of measures to provide more weight to outcome/clinical measures
2. Rewarding contracts for quality improvement
3. Reducing overall and/or summary Plan Ratings for contracts with serious compliance issues
4. Controlling for concentration of providers in a geographic area
5. Addition of an icon for high-performing plans
For 2013, she mentioned these potential additional measures:
1. Survey measures of care coordination
2. Case-mix adjusted mortality rates
3. Preventable hospitalizations
4. Serious reportable adverse events
5. Grievances
6. Use of highly rated hospitals by plan members
7. Medication therapy management measures
8. Evaluation of a contract’s Chronic Care Improvement Program (CCIP) and Quality Improvement Project (QIP)
RISE would like to thank Liz for her participation in the event.
Watch this blog for more industry updates; we’ll be including more news from our events in the months to come.
Lori Medlen, Executive Director
RISE
