Using a Systems Approach to Improve Star Ratings

At the end of a 2018 JAMA article discussing a systems approach to medication adherence, it states:

“Our challenge now is to identify and address the interdependence of components across the health care system to design an error-proof system for medication adherence.”

Challenge accepted.

Star Ratings Strategies at Each Touch Point of Care

In reality, a systems approach to healthcare is something CMS and others have been working toward for years. Take CMS’s Star Ratings system for Medicare Advantage Part D (MAPD) plans, for example. The structure of the ratings and corresponding cut point measurements were designed to reward MAPD plans’ efforts to strengthen weak areas of the system, thereby resulting in better care and improved outcomes for members. However, without applying systems thinking to all areas of care, it can become increasingly difficult for health plans to meet ratings requirements. That’s where we come in.

Related Resources

6.29.22

by Patricia Powers, PharmD

How Mosaic’s Comprehensive Pharmacy Support Enables Better Care at Home

As the Director of Clinical Services at Mosaic Pharmacy Service, Patricia Powers, Pharm.D. is responsible for overseeing the development and delivery of clinical services for all Mosaic members, RxAnte’s high-touch pharmacy service. This month we asked Dr. Powers to share her insights around at-home care coordination benefiting both the patient and the health system and how Mosaic’s comprehensive pharmacy support can help enable better care at home.

5.25.22

by Tori Erxleben Rush, PharmD

CMS Announcement for Medicare Advantage Part C and D plans

In early April, the Center for Medicaid and Medicare Services shared its Announcement for Medicare Advantage Part C and D plans, incorporating feedback solicited after an Advance Notice was issued in February 2022. Overall, not much has changed since the Advance Notice, however CMS addressed the comments issued by Medicare Advantage stakeholders like MA organizations and prescription drug plan sponsors.

4.4.22

The need for value-based pharmacy services

There is a strong push among physicians to transition to care models that incentivize fewer, more effective treatments. This same perspective should also be held in pharmacy. As we look to a post-pandemic healthcare system, improvements need to be made to remedy these concerns with focuses on barriers to optimal quality and cost--particularly for the medically complex and socially vulnerable.