Diabetes And Medicare Star Ratings

Do you know what the Medicare Star Ratings are?  If not, you might want to review the Kaiser Family Foundation brief from last year.

Basically, the star ratings provide individuals with a quality rating across numerous dimension on a Medicare plan.  And, they are helping to drive the pay-for-performance (P4P) focus across healthcare.  This year’s changes include several adherence metrics and have brought the total diabetes measures up to 7.  And, if you happen to be one of the few 5-star Medicare plans, you will be able to have open enrollment all year not simply during the AEP period from 10/15-12/7.

Here’s a quick summary of the seven (lots of opportunities to work with communications to improve ratings and outcomes):

Measure Summary
Cholesterol Screening Percentage of diabetics with an LDL  test
Eye Exam Percentage of diabetics with an eye exam
Kidney Disease Monitoring Percentage of diabetics with a kidney function test
Blood Sugar Controlled Percentage of diabetics with an A1c test showing their blood
sugar under control
Cholesterol Controlled Percentage of diabetics with an acceptable LDL value in their cholesterol test
Treatment Percentage of diabetics with both a diabetic medication and a hypertension medication that are getting an ACEI or an ARB
Adherence to Oral Rxs An average Proportion of Days Covered (PDC) greater than 80%

We all know the statistics on diabetes so hopefully this will help to improve outcomes.  If you’re interested in how Silverlink helps plans with Star Ratings – go here.

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