Latest CMS Star Ratings Spur Interest in Clean and Complete Clinical Data

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Verinovum's focus on member experience reflected in HEDIS measures and CAHPS results drives interest in new Medicare Advantage data gap assessment

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It’s going to come down to having the best quality clinical data so each organization can achieve their best quality and financial outcomes.

Following the release of the 2021 Medicare Advantage (MA) Star Ratings, health plans are seeking better ways to improve clinical data quality to meet digital quality measures. Star Ratings thresholds and requirements become more stringent year after year, creating challenges for health plans to keep up.

The MA Star Ratings system helps Medicare beneficiaries, their families, and their caregivers compare the quality of Medicare health and drug plans. Medicare health and drug plans are rated on a one-to-five scale, with one star representing poor performance and five stars representing excellent performance.

Verinovum, a health data curation and enrichment technology company, has taken notice and is offering solutions. “A health plan with a Star Rating of 4 in 2020 may have slipped to a 3.5 in 2021, even if their member satisfaction and quality scores remained the same,” said Verinovum Chief Strategy Officer, Mike Noshay. “It’s going to come down to having the best quality clinical data so each organization can achieve their best quality and financial outcomes.”

In response to the increased demand for better quality clinical data, Verinovum has launched a risk-free data assessment to help payers analyze the quality and completeness of patient clinical data. The assessments will help MA plans learn where their clinical data can be improved to positively impact Star Ratings and improve member experience.

Utilizing Verinovum’s Data Curation as a Service (DCaaS) solution, the Tailored Medicare Advantage Data Gap Assessment will analyze six-to-nine months of a plan’s clinical data for the plan’s most prioritized measures. The in-depth analysis can take 60-90 days. Once complete, Verinovum will present a report that outlines the data quality and where improvements can be made that have a tangible impact on the plan’s most pressing use cases.

The assessment will show payers ways to materially impact data quality and improve processes for:

  • Transferring data from commercial products to retain members
  • Enabling ease of clinical data exchange with providers
  • Building more robust data across fragmented encounters

“We want to help payers really get the most from their clinical data,” said Verinovum CEO Mark McCurry. “Something as simple as using different date and time formats from one system to another can cause data integrity problems that negatively impact reporting, downstream application use, and ultimately member satisfaction and Star Ratings. We know how to identify those problems and curate and enrich clinical data. When payers see their Data Gap Assessment reports, they’ll be able to see exactly where they can make changes that will impact their bottom line.”

Click here to learn more about the Tailored Medicare Advantage Data Gap Assessment.

About Verinovum
Verinovum is a market leader in clinical data curation and enrichment, enabling payers, providers, and partner organizations to improve operating performance and quality with actionable data. By delivering clean, complete, and accurate data, Verinovum supports healthcare organizations in their efforts to access the right information, in the right format, at the right time, so it may be tailored and curated to fulfill specific use cases and achieve mission-critical clinical and business goals. Discover more at Verinovum.com.

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Rita Murphy
@VeriNovum
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