The U.S population is aging fast. By 2030, the number of people over the age of 65 will have grown to 74 million, from 46 million in 2016.
Correspondingly, Medicare Advantage enrollment has nearly doubled over the past decade. Medicare Advantage is now the fastest-growing section of the health insurance market—at the epicenter of intense competition between insurance payers.
CMS measures how well Medicare Advantage plans perform with its Star Ratings System. Used to assist potential members in their plan selection process and assess the quality of care delivered, the system rates plans from one to five stars.
Plans that achieve Star Ratings of 4 and above are awarded quality bonus payments (QBPs) in the form of an additional 5% in annual revenue.
More, 5-star rated plans can enroll members all year round—securing unfettered access to all Medicare Advantage lives in the market.
To succeed, payers need their plans to perform exceptionally.
Many payers struggle with getting their plans to 4 stars and above AND keeping them there. The major challenges they face include:
- Low provider participation
- Keeping up with cut point increases and changes
- Low patient satisfaction and CAHPS Health Plan Survey performance
As they aim to improve care quality and outcomes for Medicare Advantage patients, providers face some obstacles:
- Inaccessibility of comprehensive patients clinical data and medical history
- Treatment plan and drug adherence gaps that affect outcomes
A unique demographic, with widely varying new technology capabilities, the challenges seniors face as patients are:
- Technology-related barriers to taking control of and managing their healthcare
- Long wait times and delayed feedback from health plan call centers and physician’s offices
Aster Health’s Solution
An ambient voice technology-powered platform bridging the information gap between providers and patients.
Here’s how all parties benefit:
Government-sponsored payers gain what they need to improve their Medicare STAR ratings and CAHPS Health Plan Survey performance. With Aster Health, they can:
- Simplify patient interactions with providers and health plans
- Give members’ access to timely care
- Eliminate long wait times and feedback delays—enhancing the patient experience
- improve patient satisfaction
- Provide network providers with access to key clinical data needed to deliver comprehensive care.
Using any Amazon Alexa or Google Voice device, providers can effortlessly access 4 years of patient claims data at the point of care. Aster Health lets providers:
- Gain access to patient claims and clinical data—allowing them see beyond their individual EHRs
- Identify HEDIS and drug adherence gaps and address them speedily
- Provide more comprehensive care, implement preventative measures, and achieve better outcomes
Our ambient voice technology appropriately considers the demographic and their varying technology skill levels. With a few voice commands, patients can
- Connect directly to available providers
- Schedule in-office or telemedicine appointments with providers
- Access their medical and health plan information quickly and easily
- Request prescription refills, set reminders, and chat securely with providers
Aster Health’s platform is HIPAA-compliant and utilizes FHIR, the flexible, modern data exchange standard EHRs are designed around. The platform accesses patient claims data through CMS’ Blue Button 2.0.