- Modular program enables Medicare insurers to tailor Stars initiatives to address unique member and physician opportunities
- Member engagement and data integration key to improving care, goal of CMS Stars ratings
TRUMBULL, Conn. (June 30, 2015) – HPOne today announced the availability of its Stars Solutions program which supports Medicare Advantage plans as they strive to improve their quality of care, as reflected in their CMS Star Ratings.
“The HPOne program enables executives at Medicare Advantage plans to close care gaps and improve medication adherence, leading to an improvement in their performance relative to Star Ratings,” said Bill Stapleton, founder and CEO of HPOne. “We are committed to helping insurers achieve performance improvements, and our pricing takes into account whether our clients have improved their targeted Star measures relative to CMS cut points.”
The HPOne solution is unique because it centers on a connection with the health plan member, backed by state of the art technology in data analytics and CRM. HPOne-trained Care Coordinators reach out to members in targeted outreach campaigns, helping members to make appointments for necessary screenings and tests and to adhere to prescribed medications. Through partnerships with leading data analytics firms, HPOne works with health plan clients to create accurate patient call lists with a full complement of information to facilitate dialogue. HPOne’s state of the art CRM system enables Care Coordinators to record key information at the point of contact, such as the catalyst for care.
Underlying the effectiveness of the program is HPOne’s expertise in working with members over the phone. In 2014 the company handled over 500,000 calls, from helping seniors navigate the often complicated process of choosing the right health plan to onboarding and retention calls on behalf of national and regional carriers. Through its comprehensive Secret Shopper program, the company assists health plans in configuring their call center operations to achieve 5 Star performance relative to the Centers for Medicare and Medicaid Services (CMS) guidelines for call center performance.
HPOne’s Stars Solutions helps insurers address the key factors that CMS uses to determine Star ratings for insurers’ Medicare plans. The company creates a customized approach for each client, focusing on data analytics, consumer outreach and outcomes intelligence.
- Four customizable modules of Stars Measures – Insurers can utilize a combination of the following for targeted outreach campaigns to their members: preventive and screening (including flu vaccines and breast cancer screenings); diabetes (including medication adherence and blood sugar control); member experience (access to care and customer service); and pharmacy (high risk medication and prescription adherence).
- Member- and patient-focused outreach – While outbound calling is at the core of its outreach programs, HPOne uses a full complement of outreach media and methods including phone and email campaigns, direct mail, and text messaging and can augment the contact strategy with carrier-specific incentives for targeted populations.
- Care coordination – HPOne provides insurers with the level of support they need to help their members get access to high quality, effective care by addressing both individual barriers to care as well as working with physicians practice groups whose members are not meeting care guidelines.
- Outcomes analysis – Weekly outcomes reporting keeps insurers up to date on their progress towards established goals for specific Star measures. The HPOne program also uses the opportunity of member interactions to create robust member profiles, laying the groundwork for improving the overall quality of care across multiple Star measures.
For more information on HPOne’s Stars Solutions, visit http://www.healthplanone.com/stars-solutions.aspx.
Founded in 2006, HPOne is a leading sales and marketing organization that operates across multiple segments of the Medicare and health insurance marketplaces. Using proprietary technology solutions coupled with deep industry knowledge, the company provides a range of outsourced sales, marketing and contact services for national and regional health plans, operates private exchanges for individual consumers and employer-based group retirees, and manages the largest exclusive Medicare lead generation marketplace in the industry. HPOne’s core differentiation is our exclusive focus on the health insurance industry, bringing innovative and performance-based solutions that address the most pressing challenges facing our clients. With four state-of-the-art contact centers around the country and a management team with an average of over 15 years in the health insurance industry, HPOne provides our clients with the solutions they need to profitably grow and manage their business. For more information, visit www.HPOne.com