Effective Stars management requires complex orchestration of nearly every part of the Payer organization. Reliable, fresh and easy-to-use data is essential for effective Star management.
Measures are becoming more complex, including holistic rather than episodic (readmissions transitions of care, etc).
Weighting of measures is changing as CMS puts more emphasis on the measures they believe are now most important, which are often the hardest to achieve.
Tukey method of removing statistical outliers changes Star measure cut points, which has most impacted the best performing plans.
2022 pandemic allowances have been discontinued exposing many plans’ loss of focus and erosion of capabilities that drive Stars performance.
The core mission of every Payer is to enable positive health outcomes for its members while building a healthy business. Executing this requires sophisticated analytics and reporting that needs to be fueled by timely, accurate data.
What’s making it harder to manage medical costs?
Regulators are closely scrutinizing or reining in the ability to perform prior authorization & utilization management. Administrative costs often outweigh savings.
Plans lack the technical infrastructure and analytics tools and expertise to evaluate medical economic trends in a timely manner.
Plans find it hard to link important medical and pharmacy claims, authorizations, care management status, and member and provider details to improve outcomes.
Analysis timeframes are long and prone to dirty data. By the time medical economic analyses are done, episodes have passed and clinicians have lost their ability to intervene.
Payers have access to all the data needed to make great decisions and run an efficient business. The problem is getting the right data sets at the right time in an easily usable format.
Lilac’s powerful data integration engine automates the aggregation and normalization of data from any corner of the Payer ecosystem. The data is then stored using leading HIPAA-compliant storage and container solutions. The result is a normalized “source of truth” data foundation that your organization can build robust analytics, dashboards, reporting, or workflow solutions on top of.
Connect with the Lilac team to discuss how our Platform can solve your specific challenges
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