Health Plans, Health Systems, Medicare Advantage | By | 03/03/22 | 3 Minute Read

3 Ways Health Plans Can Improve Their Star Rating

No matter what industry you are in or what service your organization provides, everybody likes to get positive reviews and high ratings. For health plans, having a good STAR rating and knowing how to improve your rating, is a key metric of success for both the quality of care and customer service that the plan provides. Let’s take a quick look at three best practices that may help improve your member satisfaction, retention, and overall rating.  

Rethink Your Onboarding Process to Focus on Medication Benefits

The onboarding process is an important welcoming piece of the member journey. However, the process can often be too short-sighted, as health teams may be concentrating only on getting the member successfully signed up and mailing out their new ID card. Think of onboarding as a crucial first impression that will set the stage for the rest of your relationship with your members.

Typically, a member first uses prescription benefits just after they enroll. Since it will usually be their first benefits experience, making that experience positive is key. This is especially true for those who have chronic conditions, as they need to have a full understanding of their prescription benefits and what they can expect.

So how can you best assist your members? Health plans can provide valuable help to their members by using medical and pharmacy claims data to identify medication nonadherence, and then reaching out proactively to members. Helping people understand their benefits–and identifying any barriers to care–are critical to ensuring a positive experience and better outcomes.

Use a Calendar to Reach Out to Members Often and At Meaningful Times

Knowing when to reach out to members can be helpful in making an impact. Consider these three recommended outreach opportunities:

  • Reach out each year in February, ahead of CAHPS survey. The CAHPS survey, conducted every spring, is a major calibration tool of STAR ratings. By the time the government takes the survey, it is too late to affect the outcome. So health plans need to be proactive with members and reach out early in the year. Solving an issue for a member ahead of a CAHPS survey is a win/win.
  • Reach out ahead of annual plan changes. Annual plan changes potentially involve price increases, changes in prescription drug coverage, and other differences from the previous year. Reaching out before a price change improves your chances of keeping your members. If a member has a drug that is unexpectedly becoming more expensive, there could be generic equivalents to prescription medicines that can save them money. Though the price for the current plan may be increasing, you may have another plan within your portfolio that will be a better fit, based on the changes.
  • Reach out a few times a year to check on your members. Ensure that your members are going for annual wellness visits, getting recommended preventative tests, and receiving flu shots.

Leverage Different Channels to Find What Works Best for Your Members

Health plans need to ensure that vital information is reaching its members, which can be challenging. For example, a recent survey found that only 37 percent of plan consumers had received information regarding COVID-19 from their plan providers in May 2020, months after the global pandemic had first been reported.

Members will have different preferences when it comes to receiving communication. A good way to improve the consumer experience is to diversify communication channels based on consumer preferences. Some may prefer digital channels, whereas others want to receive snail mail or a telehealth option—let them choose, if possible. And remember to stay modern and relevant with the millennial members, who may prefer email or only text updates. Being a communication superstar can help your ratings be rising stars.

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