April 6, 2023
By providing high-quality care to patients in a timely manner, providers play a critical role in the star ratings program. There are different opportunities for providers to engage with patients to help ensure high quality and timely care while helping patients manage their health.
Areas of opportunity to align provider practices with the CMS star ratings program:
- Promote timely and appropriate screenings, tests, and treatment
- Provide education to staff members for proper documentation of care delivered
- Strengthen patient and provider relationships through open communication regarding health care needs and quality of care
- Collaborative development of chronic condition care plan
- Follow-up with patients regarding medications
- Assess timeliness of care and work with office staff to optimize scheduling
- Reference HEDIS measure tip sheets
These practices promote patient safety, preventive medicine, early disease detection and chronic disease management, which is especially beneficial for this population.
Star ratings help members enhance relationships with providers and health plans by ensuring accessibility to care, enhanced quality of care and optimal customer service.
For more information, contact ProviderClinicalConsulting@Premera.com
This article is the third in a series about the Centers for Medicare & Medicaid Services star ratings program. Learn more in the first and second articles.
Healthcare Effectiveness Data Information Set. HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).