EY Medicare Advantage Stars Terminal

What EY can do for you

For Medicare Advantage health plans, star ratings across about 45 key performance indicators can make all the difference in securing a larger share of the market — and a bonus from the Centers for Medicare & Medicaid Services (CMS) to the tune of $29 to $35 per member, per month, among other benefits. Yet each measure is weighted differently, and the cut-point thresholds for star ratings in each measure are not shared in advance.

Using an end-to-end approach with intuitive insights through dashboards and last-mile integration, the EY Medicare Advantage Stars Terminal platform demystifies how plans can boost their star ratings, leveraging data to avail CMS bonuses and rebates. It’s your conduit for turning these difficult, abstract and disparate measures, based on many data sources, into improved star rankings, better care and greater performance, with quantifiable returns.

A range of variables shown below, including the Consumer Assessment of Healthcare Providers and Systems (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS), Health Outcome Survey (HOS), Prescription Drug Event (PDE), Independent Review Entity (IRE) and Admin, are assessed and analyzed, helping to uncover areas for targeted intervention and optimization, reveal impactful steps to drive results and measure progress for continuous improvement. It’s a three-step process: