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How to Improve Quality STAR Scores Using Targeted Patient Campaigns

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As a medical provider, you want to do the best job you can serving your patients and managing your business.

A big part of doing so is monitoring and improving your facility’s Medicare Quality STAR scores. Good quality STAR scores are crucial for medical providers. Quality measure campaigns have been shown time and again to be cost-effective in reducing readmissions, achieving lower mortality rates, and reducing hospital length of stay.

One powerful way to improve your Quality STAR scores is through targeted patient campaigns. These campaigns focus on a specific population or subset of patients and are designed to improve care for that population. Member-facing campaigns are a popular strategy to engage and educate your members within a fixed time frame. Using emails, text messages, and phone calls to provide targeted education messages can drive significant behavior change in patients.

As founder and CEO of 400-person Medicare platform EasyHealth, David Duel has overseen efforts to improve patient outcomes by combining healthcare and insurance services. He says, “Medical practices that use targeted patient campaigns to drive changes in patient behavior dramatically improve their Quality STAR scores. By combining patient segmentation strategies, high-performing medical providers deliver targeted messages that provide information based on each person’s condition or needs.”

We will discuss how gap opportunity assessments and targeted patient campaign strategies can improve your Quality STAR measurement scores.

Quality STAR Is a Measurement Tool for Assessing Quality of Care

Star ratings used to measure the quality of care are a common topic in healthcare. This is especially true for those who participate in Centers for Medicare & Medicaid Services (CMS) Star Ratings.

This image is a depiction of the intersection of CMS desired gaps/measures for review in the STARs program and what EasyHealth can provide process-wise across EasyHealth care delivery models to close each respective gap. David Duel adds, “EasyHealth comprehensive clinical review covers the majority of STAR measures through field visit or in-home assessment with followthrough into virtual AWV to ensure gap capture is completed.”

How Focusing on Patient Engagement in Preventive Care Campaigns Improves STAR Scores

David Duel continues, “It’s vital to consider patient involvement while executing campaigns. Increasing engagement with patients early and often results in better gap closure performance for activities requiring direct action, indirect action, ongoing management, and clinical visit completion.”

At EasyHealth, we’ve discovered a link between engaging patients in their own stories and enhanced preventive care more generally across Medicare, Medicare Advantage, and Medicare Dual Enrollment populations. We attribute our increased involvement to several processes:

Using tailored messages that are suited to each population’s requirements

Providing clients with the answers to insurance and health plan queries, such as what facilities are in their network, what medicines are covered, and more

As a result, we discovered that more invested patients are engaged in their treatment and have better coordination of care. It’s important to engage patients and serve as an ongoing support agent for all patient inquiries and demands in order to enhance patient engagement. These factors appear to be crucial components for improving quality measurement adherence and completion, resulting in improved health outcomes and shared savings.

How Patient Segmentation Can Improve Quality Scores for Specific Conditions

Many of members’ overall quality STAR measurement is caused by medical problems. It’s critical for a group or plan to have a clear focus, which can be achieved through patient segmenting based on illnesses with several associated measures.

However, the extent to which analytics capabilities vary is debatable. Directly targeting people based on certain characteristics, such as a disease level, is a typical formulaic method to target populations. This approach works well for diseases like diabetes. Here are some of the strategies we’ve discovered that deliver better results:

Tailored messaging with instructional content.

Consideration of call to action campaigns; reducing the amount of time it takes to conduct a review.

Patient rewards given for establishing a doctor-patient relationship.

Supporting ongoing management through remote patient monitoring efforts.

How to Carry Out a Targeted Patient Campaign

Using cohorts within your analytics software platform unlocks views into how particular groups or sub-groups compare with the population as a whole. By identifying these segments, organizations have developed targeted campaigns based on what is most appealing to each group. Some examples include:

Patients who are noncompliant with medications;

Patients who refuse recommended procedures due to cost concerns;

Patients who have been admitted to the hospital due to certain risk factors and can follow certain protocols/instructions that are known to help reduce readmissions, hospitalizations, and other adverse outcomes.

The success of targeted patient campaigns is a result of how customized they are for specific populations. Marketing efforts should be tailored towards the target audience, including age, ethnicity, socioeconomic status, and other factors such as language.

Organizational Goals Steer Targeted Patient Campaigns

Although targeted patient campaigns can improve quality scores across the population as a whole, it is important for medical providers to keep in mind their overall organizational goals when developing these efforts. The objectives of care coordination and population health management should be kept in mind when designing interventions.

For example, an organization may want to improve quality scores for a specific condition, such as diabetes, coronary artery disease (CAD), or asthma. However, the intervention cannot conflict with the goals of care coordination and population health management. In some cases, it’s necessary to focus on just a sub-group of the population that is afflicted with the condition instead of trying to improve quality scores for everyone at the same time.

With patient engagement and experience becoming increasingly important in overall quality performance, considerations on how and where an organization outreaches to and activates their patients are needed. Organizational goals should drive patient campaigns, and efforts should be made to pinpoint whom they affect most.

Targeted patient campaigns can improve quality scores for specific conditions, but it’s important that the overall goals of care coordination and population health management stay in mind when developing these interventions. This is an emerging area of focus for many medical organizations and will continue to be a major focus for healthcare reform in the future.

Follow through on campaigns and service excellence are critical. Patient engagement and experience are becoming increasingly important in overall quality performance.

Conclusion

In order to improve quality STAR measurement scores and better achieve organizational goals, it is important for medical providers to carry out targeted patient campaigns. These campaigns can be developed specifically to target groups or subgroups of people based on their demographics and other factors. When this is done effectively, organizations will better achieve their goals as well as improve quality scores across the board.

For further reading about EasyHEalth see: EasyHealth, a startup targeting the Medicare experience, announces $135M Series A

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