New Contract Medicare Star Ratings: Why The Sudden Cliff?New Contract Medicare Star Ratings: Why The Sudden Cliff? On average, contracts receiving their first star rating receive ... Rating cliff? Value-based insurance design, Managed care 1/6/2020 12:00:00 AM ...
Description: On average, contracts receiving their first star rating receive 3.20 stars, compared to existing or established contracts receiving 3.90 stars on average. This 0.70 disparity in quality ratings creates significant hardship on new contracts when this lower star rating decreases their payments in the following calendar year. This article explores the disparity in Medicare Advantage Star Ratings between contracts receiving their first star ratings (“New” contracts) and existing contracts, including: 1. Understanding what happens to Medicare Advantage Payments when contracts receive lower star ratings? – What is the Star Rating cliff and why does it matter to new contracts? 2. Explaining when a contract receives their first star rating and how much enrollment this requires – When does the Star Rating cliff occur? 3. Noting which specific star measures “New” contracts struggle with, including those contracts under large parent organizations, contracts with rapid growth, and all other new contracts. – How can my contract avoid the Star Rating cliff?Hide
- Authors: Suzanna-Grace Sayre, Danielle Beierle
- Date: Jan 2020
- Competency: External Forces & Industry Knowledge; Results-Oriented Solutions; Strategic Insight and Integration
- Publication Name: Health Watch
- Topics: Health & Disability; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
Session 185: The Health Insurance Customer Journey: A Behavioral Finance Perspectiveclosely follow federal law. The Sherman Act, is the primary U.S. antitrust law pertaining to association activities ... enrollment Member Acquisition • Health and wellness • Care management • Social Determinants of Health Member ...
Description: Numerous behavioral finance theories have emerged in recent years, many of which apply to insurance. The presenters look at key theories and their use in explaining, predicting and inducing behavior from the perspective of the health insurance customer journey.Hide
- Authors: Lijia Guo, Randall Herman, Joseph Slater
- Date: Mar 2020
- Competency: Strategic Insight and Integration
- Topics: Economics; Economics>Behavioral economics; Health & Disability; Health & Disability>Health insurance