In the ever-evolving healthcare landscape, changes are on the horizon for the Centers for Medicare and Medicaid Services (CMS) Star Ratings Quality Measures program. With the 2026 Star Ratings release, CMS will factor risk adjustment metrics into overall Stars performance.
The integration of risk adjustment with quality measures will require health plans to break down silos. These efforts will foster collaboration and leverage data to improve performance. With major shifts underway, achieving and sustaining 4+ stars will require organizations to further evolve an enhanced member-centric approach.
Read this white paper to discover how health plans can take steps now to influence future Star Ratings, including:
- Breaking down silos to successfully integrate quality, analytics and risk management teams
- How to better invest in member engagement through coordinated activities
- Ideas for building health equity through member engagement
- Ways to effectively close data gaps and improve accuracy to gain credit for performance
Related healthcare insights
Article
Effective patient education fosters adherence to medical treatments and promotes healthy patient behaviors, in turn facilitating successful risk adjustment and value-based care.
White paper
Learn more about how Optum Enterprise Intelligence Suite (EIS) enables best practices for achieving operational excellence.
Article
Learn how the InterQual level of care team tackled a content development challenge following updated societal guidelines for acute coronary syndrome.