COVID-19’s affect on Medicare Benefit star rankings nonetheless murky: specialists


The potential long-term impacts of COVID-19 on how Medicare Benefit’s star rankings are calculated stay unclear, specialists say.

Tom Kornfield, senior guide at Avalere, mentioned throughout Fierce Well being Payer’s Digital Collection on MA this week that because of adjustments across the knowledge the Facilities for Medicare & Medicaid Companies is utilizing to calculate the rankings beneath the pandemic, the business may really feel the ripple results for sever years.

MA star rankings are typically calculated primarily based on knowledge that is two years outdated, and CMS has eased reporting necessities for this 12 months. Kornfield mentioned that future steering is unclear on how 2020 knowledge will likely be used, and the way totally different that knowledge may look because of COVID-19.

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Medicare Benefit plans might be feeling the impacts as late as 2023 or 2024 on their star rankings, he mentioned.

“There are some items that we all know and a few that we don’t know,” Kornfield mentioned.

WATCH THE ON-DEMAND PLAYBACK: Secrets and techniques to the Star Rankings: How top-performing MA plans secured their scores

Beneath strange circumstances, nevertheless, what’s the important thing to securing sturdy scores on the star rankings? Information and analytics, says Romilla Batra, M.D., chief medical officer at SCAN Well being Plan.

California-based SCAN’s membership is fully in Medicare, they usually supply a wide range of particular wants and supplemental protection for seniors, together with twin eligibles. Batra mentioned that because the care wants are so totally different between members, having actionable knowledge that is helpful at each the inhabitants and particular person ranges is important.

For instance, SCAN has a various member inhabitants, so having knowledge to establish which of them want companies supplied in languages apart from English permits the insurer to extra successfully meet the wants of these members, she mentioned.

That mentioned, the rules round star rankings are consistently evolving. Batra mentioned SCAN places plenty of effort into persevering with to evolve alongside these adjustments.

“Our purpose, our mantra at SCAN is to be one of the best at getting higher,” she mentioned.


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