One of the mistakes that Medicare Advantage plans make when prioritizing efforts to improve their star ratings is focusing only on quality measures, says Malik Abdur-Razzaq, MPH, the chair of this year’s RISE’s Star Ratings Master Class in December.
“There are so many categories that measure how you get rated and how you maintain your star ratings,” says Abdur-Razzaq, pictured right, director of marketing and enrollment for Partners Health Plan in New York. “Star ratings effect all areas of the organization…You want to be compliant in all areas of the organization if you want to maintain your star ratings. It’s not just about quality data.”
In addition to his role as conference chair at the 10th annual Star Ratings Master Class, Dec. 12-13 at the Omni La Costa Resort & Spa in Carlsbad, Calif., Abdur-Razzaq will present at a session on the effective use of sales and marketing to increase star ratings. The session will focus on member touchpoints; how sales and marketing can use those opportunities to influence members and the CAHPS survey; engagement activities; communication strategies; and effective social media and outreach programs.
Prior to joining Partners Health Plan, a fully integrated duals advantage (FIDA) plan, Abdur-Razzaq worked for a Medicare Advantage plan and was a consultant for the industry. The best practices he’ll share with attendees are helpful to all health plans because the suggestions focus on good customer service.
For example, one category that influences star ratings is member complaints, retention, and the responsiveness of customer services. One way to evaluate how well you are doing in this area is how quickly you answer the phone and respond to a member’s concern. One hint: If you notice a call coming in from the District of Columbia or Maryland, it could be the Centers for Medicare & Medicaid Services (CMS) conducting a test call. “If that were my plan, I’d route the call to the senior person on staff who is very knowledgeable and will deal with the call quickly and effectively,” he says.
He also stresses the importance of training your marketing and sales staff to know the plan’s benefits and eligibility requirements inside and out. “Whether or not you are affected by star ratings, your staff needs to be very careful when they present the plan to people and meet potential members. They need to identify themselves and show their ID card. You also want to make sure they don’t enroll people without checking to be sure the doctors that are important to them are in your network. You want to be sure the individual is eligible for the plan and two, that it is a good enrollment for the plan.”
“A bad enrollment may be because you were not transparent about something or you didn’t check their doctors carefully, and they disenroll. The goal for me is to get quality enrollments so that means you need to train your staff well,” he says.
If your plan does achieve a 4-star or higher rating, don’t rest on your laurels. “One pitfall I’ve seen is organizations get too comfortable. They think we are good, but they have to maintain those stars year after year to keep that rating,” Abdur-Razzaq says. “When organizations lose a star or stars, some people get fired. I worked at an organization that lost a star rating and the medical director got fired because the loss had to do with quality under his watch.”
The 10th annual Star Ratings Master Class will feature presentations, case studies, panel discussions, and roundtables on all factors and strategies that can impact star ratings. Abdur-Razzaq said he’s excited to chair the event because of the laser focus on star ratings and the agenda addresses the multiple functions that influence them. It’s a fantastic opportunity, he says, for Medicare Advantage health plan professionals to network and learn best practices and strategies to improve their scores.
Abdur-Razzaq will present the session, “Member retention, touchpoints and 5-star ratings: Effective utilization of sales and marketing to increase star ratings,” at 2:30 p.m., Friday, Dec. 13, the second day of the two-day conference. For more information, click here to see the full agenda, roster of speakers, venue, and learn how to register.