Why a focus on the provider is needed to achieve 4 or 5 Stars.
New analysis details how far ‘all in’ provider organizations have to go to reap risk rewards.
Details on the final Call Letter and advice for where plans should place their strategic focus in 2018.
Maximize Value
November 05, 2015
Winning on Stars: It Starts and Ends With Providers
CMS Star Ratings are do-or-die for health plans. And this year, the bar is higher than ever. Our latest analysis finds that a health plan’s Star rating is defined primarily by the behavior of its providers.
Medicaid enrollment across the United States currently encompasses ~50M individuals, of which ~40M are enrolled in some form of Managed Medicaid. The covered population is expected to continue to grow, driven by factors such as Medicaid expansion, population growth, and economic challenges in select States.
While recent reports have noted its slow start, Oliver Wyman’s Martin Graf, Jim Fields, and Parie Garg provide an update on the CMS demonstration program "Fully Integrated Duals Advantage program" and discuss where its potential lies.
