Quality Management

There Was Significant Movement Past the 4-Star Threshold in 2018 MA Star-Ratings

A little noticed fact emanating from the release of detailed Medicare-Advantage Star-ratings on October 11, 2017 was the number of contracts that either gained 4-star status in 2018 or lost their 4-star status that they had earned in 2017. Focusing on just the 55 contracts (about 15% of all contracts rated for both 2017 and 2018) that crossed the 4-star threshold (either up or down),... Read More

Top Quality Improvement Trends for 2016

Quality Management Trends | Mile High Healthcare Analytics

In recent years both providers and plans have placed increasing emphasis on quality improvement. CMS Star ratings can have a major impact on financial performance with significant incentives delivered to programs receiving 4-stars or more. The “rules of the game” for quality ratings continue to shift as CMS gains more insight on which measures drive the most positive consequences. As we kick-off 2016, we thought... Read More

Root Cause Data Integrity Issues Impact Quality

Data Integrity | Mile High Healthcare Analytics

Mile High Healthcare Analytics understands that data integrity is critical to risk adjustment and quality improvement success. In fact, data quality management is the starting point for nearly every client engagement. When it comes to quality improvement initiatives, data governance needs to be done at the individual member level and organizations must address the most common root causes of data inaccuracy. In large organizations where... Read More