Formula for CMS Five-Star Quality Population Health Management

Formula for CMS Five-Star Quality
Population Health Management

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About 90 percent of Americans in five-star Medicare Advantage plans belong to a Kaiser Permanente (KP) plan; seven of KP's eight regions have received five-star ratings from the CMS Star Quality program. With about $50 PMPM to gain from each additional star, healthcare organizations are anxious to replicate this health plan's success.

Pre-publication discount on Formula for CMS Five-Star Quality Population Health Management Formula for CMS Five-Star Quality Population Health Management examines star quality improvement strategies, including this "star czar's" successful care management efforts that have made it a leader in the five-star space.

This case study in Kaiser Permanente's total panel ownership approach is supported with advice from L.E.K. Consulting on stratifying and prioritizing strategies to improve quality ratings, tactics to engage providers and members in improvement efforts, and insight into CMS's future direction for this quality improvement effort.

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Formula for CMS Five-Star Quality Population Health Management provides details on the following:

  • Improvement strategies to drive additional star ratings;
  • Distinguishing between star rating measures that are plan-centric vs. provider-centric;
  • A prioritization framework for assessing star quality improvement initiatives;
  • Focusing on the ?right? provider/member cohorts to drive improved star ratings;
  • Provider and member engagement strategies to address areas for potential improvement;
  • Preparing for risks and challenges of future star ratings periods;
  • How Kaiser Permanente:
    • Collects data and integrates its information system to improve population health management results;
    • Uses patient registries to identify gaps in care;
    • Closes identified gaps during or between routine encounters;
    • Integrates patient messaging across multiple channels to improve patient engagement;
    • Is evolving its population health management to include additional populations; and
    • Has improved its quality reporting results from its population health management program.

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A multi-user license will provide you with the right to install and use this information on your company's computer network for an unlimited number of additional workstations within your organization for a one-time fee. To have this valuable resource on your network, or to inquire about ordering bulk copies in print or Adobe PDF, please e-mail or call 888-446-3530.

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