The Centers for Medicare & Medicaid Services (CMS) released their 2023 Medicare Advantage and Part D Rate Announcement on April 4, 2022 [1]. With a commitment to advancing health equity and addressing inequities within their policies and programs, the CMS has announced several proposed changes to the Star rating program focused on health equity. This announcement's significant theme and focus is around how the healthcare industry can realign incentives and commitments to better support health equity goals. Potential changes would be implemented as new measures and calculations, and methodology changes.
When devising Star strategies, health plans should not focus on one specific new potential measure but consider health equity broadly. LetsGetChecked’s at-home testing solutions can help members overcome barriers to equal healthcare opportunity by meeting them where they are. With our accessible and convenient home tests, health plans can improve patient experiences, health equity, and Star ratings.
CMS changes to advance health equity
Health inequities have become an even greater focus for health plans as the COVID-19 pandemic has highlighted the numerous racial, environmental, economic, and historical inequities in the healthcare industry. To further its commitment to supporting health equity and eliminating social determinants of health (SDOH) barriers, CMS has proposed a new health equity index to enhance the Star rating system. This index will collect more data on beneficiary race, ethnicity, and social determinants of health (SDOH) to close gaps in care.
Medicare Advantage and Part D plans will receive scoring dependent on a subset of the Star rating measures that encompass contract performance for health equity. New rewards will be based on equity ratings and how social risk factors are addressed by a plan. CMS has also proposed a new quality measure to assess how frequently plans screen their members for social needs such as food and housing insecurity and transportation issues. These potential changes aim to promote investments that help reduce care disparities.
The role of health plans in addressing health equity
As health equity initiatives are playing an increasingly important role in CMS programs, it is crucial for Medicare Advantage and Part D plans to commit to advancing health equity and driving comprehensive, person-centered care. The proposed CMS health equity index aims to create transparency in how health plans address inequities for disadvantaged groups and encourage them to eliminate current disparities.
Health plans can address health equity and improve their Star ratings by driving value in care delivery, developing qualitative and quantitative metrics to ensure accountability and transparency, and equitable preventive and medical benefits delivery. This includes not only offering supplemental benefits but also ensuring that these benefits address the most critical care gaps and barriers to care while complying with the requirements for supplemental benefits.
How at-home testing can help health plans address health equity
Health plans have an essential role in improving health equity and addressing SDOH such as transportation, income, discrimination, and location, which prevent individuals from having equitable access to the healthcare services they need. Addressing health equity will enable health plans to improve the delivery of quality care and patient experience and, as a result, Star ratings.
Leveraging at-home testing can advance health equity by helping individuals overcome barriers to care. LetsGetChecked’s at-home testing solutions can help health plans get a jumpstart on HEDIS and Star rating improvement initiatives by meeting members where they are. Together we can close gaps in care to improve Star ratings and meet HEDIS ratings for Medicare and Medicaid.
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