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Advance Care Planning and the Impact on Medicare Advantage Star Ratings

Advance Care Planning and the Impact on Medicare Advantage Star Ratings

New Report from MyDirectives® Says Advance Care Planning Documents Can Help Boost Medicare Advantage Plans’ CMS Star Ratings

DALLAS – April 2, 2024 – A new Industry Brief issued by MyDirectives® reports there are promising indicators that Medicare Advantage (MA) plans can positively impact their CMS Star Ratings by offering members access to advance care planning (ACP) tools and documents. MyDirectives is the leading digital ACP platform for healthcare providers, payers, and consumers.  

According to the Industry Brief, making ACP solutions available to members has the potential to increase CMS Star Ratings by improving patient outcomes and satisfaction, enhancing customer experience, and boosting the quality of provider-patient interactions, all of which are integral to these ratings. MA plans with superior Star Ratings are rewarded with higher reimbursement and bonuses. Underperforming plans receive smaller CMS payments and are restricted from marketing during the special enrollment period, thus limiting their ability to increase member numbers during the standard open enrollment period.  

“With the significant impact Star Ratings can have on Medicare Advantage plans’ revenue, bonuses, and flexibility in enrollment, it is essential to recognize the value and importance of ACP,” said Debbie Ahl, senior advisor at MyDirectives and co-author of the Brief. “We are seeing more and more CEOs who view ACP as more than a just a mere requirement to be met for Value-Based Insurance Design (VBID) Model plan participation and other programs. They recognize it as a critical element in their enterprise’s success that must be embraced and integrated into their plan’s overall business strategy.”             

According to Charles Miles, chief technology officer at TFA-Analytics and the Brief’s co-author, CMS included several new measures in its 2023 Star Ratings where ACP has the potential to help influence a health plan’s overall Star Ratings.

“Offering plan members the opportunity to create ACP documents aligns with the principles of value-based care by placing what the individual wants at the center of diagnostic and treatment plans,” said Miles. “It also fosters long-term patient engagement in primary care, potentially driving down healthcare costs while improving care quality and patient satisfaction. That makes it a win-win for both patients and Medicare Advantage alike.”

Ahl added, “Respecting patient wishes is not only a smart business decision but, more importantly, is just intuitively the right thing to do.”

The full Industry Brief can be downloaded free of charge at https://content.advaultinc.com/acp-star.

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About MyDirectives®

MyDirectives is the premier provider of digital advance care planning (ACP) tools and highly secure, cloud-based storage for anytime, anywhere access across the healthcare continuum. Our free online tool allows individuals to create ACP documents in their own words or upload existing advance directives and portable medical order forms (POLST) to store in a secure, online repository. MyDirectives also offers solutions that enable care team members to lead guided ACP discussions with their patients. With MyDirectives, payers and providers can track business insights, quality measure achievement, and CMS regulatory compliance reporting integration, while hospital and healthcare systems can easily access a patient’s ACP documents or portable medical order forms through their EHR. To learn more, follow MyDirectives on LinkedIn, X, and Facebook, or visit www.mydirectives.com.

About TFA-Analytics 

TFA-Analytics is a value-based enablement platform that helps health plans and providers deliver high-quality care to people with complex and serious health conditions. We leverage our expertise in network analysis, information technology, and capacity management to improve market performance for payers, reliable referrals for providers, and excellent care for patients. TFA acts as a conduit, removing the barriers between cost and care so people living with complex and serious illness can focus on living and their providers can focus on caring.

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