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CSS software could boost Medicare star ratings

Saturday, January 28, 2012 10:24 AM

A new service from Clinical Support Services (CSS) aims to help Medicare plans improve their 2012 star ratings.

The Star Ratings Booster technology platform helps Medicare Advantage and Medicare Prescription Drug Plans support and enhance quality performance ratings. The module enables CSS clinicians, with the support of clients’ pharmacy and medical claims data, to determine a patient’s compliance on select Part C/D measures and generate comprehensive care-enhancing recommendations for the patient, which then may be shared with the patient’s physician and/or pharmacy.

CSS’ web-based module enables pharmacy claims—and other available clinical data—to be uploaded to the client’s patient profiles. The MTMPath module allows CSS clinicians to identify patients who are non-compliant on certain Part C/D measures that would have a negative impact on a plan sponsor’s CMS Star Rating, said CSS president James Notaro, RPh, Ph.D. When a measure is tagged as non-compliant, CSS reaches out to the patient and his/her physician to bring the measure into compliance. This feature gives CSS the potential to improve star ratings measures over time.

Star Ratings Booster has an unlimited patient capacity and was built in accordance with the latest HEDIS-based guidelines.

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