CMS 5-Star

Background

We can help illuminate the intricacies of managing and improving CMS 5-Star Ratings, cut points, and roadmaps. Discover insights, strategies, and industry proven performance to assist both providers and plans in their endless pursuit of excellence, outcomes, and patient satisfaction.

Welcome to our cutting-edge CMS 5-Star Consulting Services! At CareOne Consulting, we recognize the critical importance of CMS 5-Star ratings in today's Medicare Advantage landscape, and we're dedicated to helping you achieve and maintain top-tier ratings through strategic guidance and tailored solutions.

Our comprehensive CMS 5-Star consulting services are designed to elevate your organization's performance, ensuring excellence in every aspect of CMS 5-Star rating measures and criteria.

Key Ways Our Clients Utilize Us:

Rating Enhancement Strategies: Drawing on our extensive expertise, we develop customized strategies to improve your CMS 5-Star ratings, focusing on targeted interventions and performance improvement initiatives across all relevant domains.
Data Accuracy and Validation: We conduct thorough assessments of your data collection, validation, and reporting processes, ensuring accuracy and completeness to support optimal CMS 5-Star ratings.
Quality Improvement Initiatives: Our team collaborates with you to implement quality improvement initiatives aimed at addressing gaps and driving measurable improvements in key areas identified by CMS for star rating calculation.
Provider Collaboration and Alignment: We facilitate collaboration between your organization and provider network, fostering alignment with CMS 5-Star measures and standards through education, training, and performance incentives.
Performance Monitoring and Benchmarking: Utilizing advanced analytics and benchmarking tools, we monitor your performance against CMS 5-Star benchmarks, providing actionable insights and performance metrics to guide ongoing improvement efforts.

Join the ranks of health plans, provider groups, and healthcare organizations that have achieved top-tier CMS 5-Star ratings with the support of our consulting services. Let us be your strategic partner in achieving CMS 5-Star excellence, enhancing member satisfaction, and driving overall organizational success.

Related Insights

5/1/24

CVS Made a Big Bet on Medicare. It’s Looking Risky

The healthcare giant cut its guidance for 2024 yet again

4/23/24

CMS Publishes Final Rule on PACE

The Final Rule gives CMS additional grounds on which to deny PACE organizations’ initial and service area expansion applications, imposes immunization requirements on staff who have direct contact with PACE participants, establishes deadlines for reviewing recommendations and scheduling services for PACE participants, and alters the grievance resolution process.

4/11/24

Medicare leaders discuss accountable care growth as part of NAACOS conference

Collaboration across CMS centers and with ACO participants is key.

4/1/24

CMS finalizes Medicare Advantage, Part D payment changes for CY 2025

Few surprises or material changes from the advanced notice. Plans may see wildly different impacts based on their population and programs.

2/9/24

Medicare Advantage headwinds didn't prevent payers from turning a profit in 2023

Though a spike in utilization among seniors slammed payers last year, particularly in the fourth quarter, each of the six major national firms turned a profit in 2023.

1/31/24

CMS Releases Proposed Payment Updates for 2025 MA and Part D Programs

Payers up against slight decline in 2025 Medicare Advantage payments

1/25/24

Humana posts $541 million loss in Q4, blames high Medicare Advantage costs

Humana's stock dipped following the earnings report, prompting the organization to cut its earnings guidance for this year and next.

1/5/24

US managed care companies lagged behind other insurers, S&P 500 in 2023

Shares of US managed care carriers generally underperformed other types of insurers and the wider market in 2023

Back to Services