Medicare Stars Podcast
The Medicare Stars Best Practice Podcast will feature conversations with managed care leaders and staff on a variety of issues that influences performance and attainment of overall 5 Star Ratings.
Episodes
In this episode, we shine a spotlight on two essential components of healthcare quality measurement and improvement: the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey and the Centers for Medicare and Medicaid Services (CMS) Star Ratings. Join us as we uncover the intricacies of these programs and their role in driving excellence in health plans.
The CAHPS survey serves as a vital tool for capturing patient ...
In this episode, we delve into the profound significance of data in addressing health equity, and how it can be a catalyst for transformative change. Health equity remains a critical challenge in our society, with disparities in access to healthcare and health outcomes persisting across diverse populations. The key to tackling these disparities lies in understanding the root causes and implementing targeted interventions. Join us a...
RADV has become increasingly important in today's landscape, as it directly impacts the financial stability of healthcare organizations. It involves a comprehensive review and validation of the clinical data used for risk adjustment, which determines reimbursement levels for health plans and providers. Join us as we uncover the intricacies of RADV and explore strategies for maximizing accuracy and compliance in this crucial pro...
In this episode, we dive into the dynamic world of health plans and uncover effective strategies for driving meaningful quality improvements in these complex organizations.
Health plans play a crucial role in the delivery of healthcare, acting as the bridge between providers, payers, and patients. As the industry continues to evolve, it is imperative for health plans to adopt robust quality improvement strategies that not only meet...
In the episode, we delve into a topic that has gained significant attention in recent times—burnout and wellbeing among quality professionals.
Join us as we explore the challenges faced by these dedicated individuals and discuss effective strategies to maintain a healthy work-life balance while pursuing excellence in their roles. Burnout has become an all-too-familiar experience for many quality professionals. The relentless ...
Globally, healthcare leaders are progressively looking to embed the principles of continuous improvement in their organizations. Enabling staff to deliver safe, equitable, high-quality, reliable care can provide a step-change in results. In this episode, Tracey provides tips on building a continuous improvement culture.
Guest: Tracey Papas
Listen in to The Medicare Stars Best Practice Podcast for discussion, insights and perspe...
What will be the impact if every provider understands the importance of submitting CPTII and also complies? The world of quality will be much easier as submitted encounter codes will close gaps and plans will have no need for chart retrieval activities that requires resources on both sides✅ 👍👌
In this episode we discussed the importance of CPTII codes in addressing care gaps, provider barriers to utilizing CPTII codes and providi...
In this episode, we talked about the financial implications of CMS proposed changes and what plans can do to mitigate these headwind changes. Rex is the guest on this episode. Rex is a quality consultant with over 30 years of experience, the CEO of Rex Wallace Consulting. RWC was created to help health plans improve Quality.
Guest: Rex Wallace
Listen in to The Medicare Stars Best Practice Podcast for discussion, insights and perspe...
Katharine is a HEDIS auditor, the president of Healthy People; with 25 years of experience. She is also a member of NCQA's Data Collection Advisory panel. Health People is a HEDIS audit firm.
This episode is a deep dive into 2024 CMS AN, Proposed Rules, and HEDIS Public Comments released on February 13, 2023. Katharine also provides strategies on how plans can succeed with respect to these proposed changes.
Guest: Katharine Isk...
In this session, we discussed the importance of CAHPS to Medicare Stars, and Valerie provided ways to improve CAHPS results through a partnership between healthplans and providers/healthcare organizations. She explained why setting the right expectations with members is key to member experience and provided examples of how to manage expectations. Listen to hear more.
Guest: Valerie Choniuk, MPA-HCA, CPXP
Listen in to The M...
Phil shares some tips that can help in the management of an effective HEDIS season. In addition, he also provides information on 2023 CMS HEDIS changes and perspective for the future of HEDIS. Listen to hear details.
Guest: Philip (Phil) Collins.
Listen in to The Medicare Stars Best Practice Podcast for discussion, insights and perspectives from subject-matter expects knowledgeable names in the managed care industry....
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