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How Data-Driven Strategies Are Revolutionizing CMS Star Ratings In Healthcare
Forbes Technology Council – CMS Star Ratings guide consumers in selecting healthcare plans that fit their needs, with higher ratings
AdhereHealth™ supports the managed care industry, self-insured employers and other risk-bearing entities in engaging all members of the risk spectrum in adherence for improved health outcomes. We specialize in engagement of the highest-risk, hardest-to-reach member cohort through our innovative solutions, powered by our proprietary technology. AdhereHealth enhances quality of care and cost outcomes—all with a foundational SDOH-first approach for improved health equity.
Our unique combination of predictive analytics, intelligent clinical workflow software and proactive telepharmacy outreach, performed by a nationwide team of licensed clinicians, improves performance on government-sponsored pay-for-performance programs, and value-based cost reduction.
Drive performance improvement on Star Ratings and government-sponsored P4P programs through a data-driven, SDOH-first approach to medication adherence, especially in the highest-risk members.
Leverage AdhereHealth's healthcare technology, available on its own as SaaS and underlying all our proprietary solutions, to drive maximized value-based reimbursement and cost reduction.
Maximize reduction of drug therapy problems (DTPs) and improve medical cost savings through predictive analytics with aligned medical and prescription claims review, plus other opportunities for additional savings
AdhereHealth programs drive Part D performance improvement* by targeting at-risk members and resolving SDOH challenges to achieve and maintain adherence.
Our solution provides:
Our SDOH-first approach is powered by our proprietary Adhere Platform and utilizes sophisticated daily predictive analytics, which leverage a combination of plan-provided data and publicly available SDOH data, to identify members at risk of non-adherence. Our robust healthcare analytics (available as SaaS or in tandem with our nationwide clinician team) empower the efforts of outreach clinicians to help members tackle the barriers to adherence. This paves the way for long-term, longitudinal adherence and increased performance on Part D / pharmacy measures for government-sponsored lines of business (Medicare, Medicaid and Exchange plans).
We impact the following measures:
*Addressing the needs of Medicare, Medicaid and QHP Exchange plans
News
Forbes Technology Council – CMS Star Ratings guide consumers in selecting healthcare plans that fit their needs, with higher ratings
Blog
The redesign of Medicare Part D has begun. Over the next few years, the Medicare prescription drug environment is going
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