Star ratings are critical to the reputation, growth, and success of Medicare Advantage plans. These ratings, awarded by The Centers for Medicare & Medicaid Services (CMS), are based on various performance metrics, including quality of care, customer service, and member experience. They are also one of the most effective ways to differentiate a plan because they verify that the organization provides high-quality care.
In this fiercely competitive landscape, it is more important than ever for Medicare Advantage plans to achieve high star ratings. To do this, they must focus on strategies that help increase member safety, engagement and satisfaction, improve outcomes and quality of life, and support better care management.
Fortunately, connected health solutions like personal emergency response systems (PERS) can play an essential role in helping plans boost their star ratings. While PERS have traditionally been associated with fall prevention and emergency response for elderly populations, Connect America’s PERS has evolved to offer more advanced features and deliver more comprehensive service offerings to help better serve aging and at-risk populations. This is why so many Medicare Advantage plans are choosing Connect America’s PERS as a valuable and cost-effective tool that can be used to address several key areas that influence star ratings.
How Can PERS Help Medicare Advantage Plans Improve Star Ratings?
Closing Care Gaps
From urgent needs to daily care, PERS help health plans close gaps in care by addressing members’ needs promptly and coordinating the appropriate services to empower better outcomes and quality of life. With continuous in-home and mobile monitoring, members have concierge-level support for a wide range of needs, all with the press of their connected health device.
Enhancing Member Satisfaction and Engagement
Member satisfaction is a key component of star ratings. PERS contribute to a sense of security and well-being, which can significantly enhance member’s overall experience with their plan. Access to 24/7/365 emergency assistance and care empowers members and their families to live in confidence and with peace of mind, knowing that help is just a button push away.
Ensuring Member Safety, Health and Quality of Life
Quick response times and access to care help minimize complications from falls, extended lie times, and other serious health events. Whether providing an added sense of security or supporting at-risk populations, health plans can leverage PERS to address various member needs. An internal analysis of over 900,000 subscribers showed that falls were attributed to just 53% of the alert calls. PERS was also widely utilized for individuals with respiratory (12.1%), pain (10.6%), GI (3.1%), cardiac (2.9%) and stroke (1.1%) related symptoms.
Improving Member Outcomes
By incorporating PERS, plans demonstrate a commitment to enhancing safety, quality of care and outcomes. Additionally, PERS with the CareSage Analytics and Reporting Platform goes a step further by providing health plans with actionable insights and unmatched visibility into a member’s mobility, activity, and risk levels. Equipped with this critical data, care teams can implement targeted interventions to prevent falls and other adverse events before they occur. An IRB-approved study with over 370 subscribers demonstrated the effectiveness of this approach, showing a 68% decrease in 90-day readmissions, a 53% decrease in 180-day readmissions, and a 49% decrease in 180-day EMS encounters.
Reducing Hospitalizations and Care Costs
An important factor impacting star ratings is the frequency of hospital admissions and readmissions. PERS can be instrumental in reducing these occurrences by offering prompt access to help in emergencies and earlier interventions for members. This helps health plans reduce unnecessary ED visits and hospitalizations, ultimately lowering care costs. Research demonstrated PERS with CareSage Analytics and tailored interventions resulted in a 31% decrease in hospitalization costs.
By enhancing member safety, reducing hospitalizations, improving satisfaction, and supporting better outcomes, PERS contributes significantly to the metrics that determine star ratings. Additionally, PERS is a highly cost-effective solution, offering an impressive benefit-to-cost ratio of over seven to one, with every dollar spent on PERS yielding $7.19 in healthcare cost savings.
As Medicare Advantage plans strive to differentiate themselves and deliver exceptional care, PERS can be a powerful tool to boost star ratings while providing significant value to members.