Gartner Research

U.S. Healthcare Payer CIOs Boost Medicare Advantage Star Ratings Using Engagement Hubs and Insights

Published: 08 August 2018

ID: G00363535

Analyst(s): Bryan Cole , Jeff Cribbs

Summary

CEOs prioritize Medicare Advantage Star ratings as a major profit driver. Quality teams that attack single measures yield incremental gains, not perennial score increases. CIOs must deploy engagement hubs and clinical data integration to improve quality across all lines of business.

Table Of Contents

Analysis

  • Medicare Advantage Star Ratings Are Critical to Financial Performance and Membership Growth
  • Increasing Benchmarks Challenge Medicare Advantage Payers in Stars and Other Quality Assessment Programs
  • Improve Stars Performance by Addressing Organizationwide Quality and Service Gaps Across Measurement Programs
  • Recommendations
    • Address the Root Business Process Causes of Quality, Member Service and Operational Gaps
    • Invest in a Core Clinical Data Integration (CDI) Capability
    • Implement Provider and Consumer Engagement Hubs
  • Drive IT-Enabled Performance Improvement

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