Tech-enabled service improves Part D Stars Adherence Ratings for Low-Income Subsidized and Dually Eligible Beneficiaries
— Patricia Meisner CEO of ActualMeds
TALLAHASSEE, FL, USA, October 19, 2023 /EINPresswire.com/ — ActualMeds, the industry leader in medication management, continues to deliver results for Medicare Advantage (MA) plans that exceed the national averages for 2024 STARs adherence ratings in the CMS annual report released last week. The Company’s solutions are proven to be particularly effective for Dual-Eligible (DE) and for Low-Income Subsidized (LIS) individuals, even as CMS continues to apply increasingly stringent performance thresholds across many measures which has resulted in a decline in the overall Part D national Star ratings for the second year in a row.
With the 2024 measurement period, CMS begins a major shift in its STARs measurement framework, replacing its general Reward Factor to provide MA Plans with additional points on their final Star ratings, with a Health Equity Index (HEI) Reward based entirely on DE/LIS/Disabled membership. Triple-weighted Adherence and other medication management measures take on increased significance for the highest risk populations of LIS and DE enrollees whose clinical risk profiles typically include multiple chronic conditions and the medications critical to their management.
ActualMed’s data-driven approach combined with care coordination is more effective because adherence to medication regimens is often impacted by complex, multi-faceted social determinants of health (SDOH) barriers like access to transportation, ability to pay, food insecurity, or language barriers amongst others. CMS’s update to the Reward Factor emphasizes an increasing focus on health equity for all and the need for health plans to develop new policies and programs to support this initiative and boost their STAR ratings, especially plans that have traditionally scored lower than the national average and struggled with this hard-to-reach LIS/DE population.
“We’re pleased with the strong results that we’ve achieved for our clients and their members through our precise targeting and high-touch care coordination of LIS and DE beneficiaries,” said Patricia Meisner CEO of ActualMeds. “Our deep understanding of how to effectively solve for SDOH matters more than ever – and that having a scalable, human interaction increases medication adherence measures for even the most challenging, highest risk members.”
ActualMeds STARs Medication Adherence Solution is different than other STARs solutions that rely on volume of outbound calls to drive outcomes. The tech-enabled service uses automated, data-driven processes to precisely target high-risk beneficiaries and increase the probability of engagement, as well as sharing medication action plans with the member’s care team, including the prescriber.
Please visit www.ActualMeds.com to learn more about how health plans can prepare for these changes and boost STAR ratings by viewing our webinar replay, Optimize STARs Medication Adherence for Low-Income Subsidized and Dual Eligible Beneficiaries.