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Clinical Care Quality

For ACO REACH Organizations, Medicare Advantage plans and healthcare providers the importance of achieving a CMS 5 Star Rating cannot be overstated. With the number of plans with over 4 Stars Ratings falling by 17% in just one year, and with more than 70% of enrollees choosing to participate only in plans with higher ratings, it is crucial to track and improve performance on every quality measure. This is where Saince comes in.

At Saince, we offer a unique combination of technology and services that can help you stay on top. Our team has extensive experience working with plans and healthcare providers to optimize performance on every quality measure. With our help, you can achieve a higher CMS Star Rating and improve patient outcomes.

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Medicare Advantage with prescription drug (Part D) coverage (MA-PD) contracts are rated on up to 38 unique quality and performance measures; MA-only contracts (without prescription drug coverage, or Part D) are rated on up to 28 measures; and stand-alone Part D (PDP) contracts are rated on up to 12 measures. Our team can help you accurately track performance on each of these measures and develop targeted strategies to improve outcomes.

Additionally, guardrails were introduced in the 2023 Star Ratings for all measures that have been in the Part C and D Star Rating program for more than three years except the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and the Part C and Part D improvement measures. Guardrails are bi-directional caps that restrict upward and downward movement of a measure’s cut points for the current year’s measure-level Star Ratings compared to the prior year’s measure-threshold specific cut points. Our team is highly knowledgeable about these guardrails and can help you navigate the complex regulatory requirements to ensure compliance and optimize performance.

By working with Saince, you can have peace of mind knowing that you are taking advantage of the latest best practices in healthcare delivery. Our team can provide guidance and support to help you improve patient outcomes, optimize revenue streams, and achieve a higher CMS 5 Star Rating. With our help, you can stay ahead of the competition and provide the best possible care to your patients. Don't wait, choose Saince today and let us help you achieve your goals!

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